Phenytoin | Caspian Tamin Pharmaceutical Company

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The primary site of action appears to be the motor cortex where spread of seizure activity is inhibited. Possibly by promoting sodium efflux from neurons, phenytoin tends to stabilize the threshold against hyperexcitability caused by excessive stimulation or environmental changes capable of reducing membrane sodium gradient. This includes the reduction of posttetanic potentiation at synapses. Loss of posttetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures.

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those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

[view] =>

those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

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• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

[view] =>

• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

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control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

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control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

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• Injection 1mg/1ml: Box of 10 Ampoules

) ) [field_pdf] => Array ( [0] => Array ( [fid] => 189 [uid] => 1 [filename] => phenytoin.pdf [filepath] => sites/default/files/pdf/phenytoin.pdf [filemime] => application/pdf [filesize] => 135404 [status] => 1 [timestamp] => 1329490364 [list] => 1 [data] => [i18nsync] => 1 [nid] => 270 [view] => ) ) [field_pharmacokinetics] => Array ( [0] => Array ( [value] => The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL. Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19. A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels. When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms. [format] => 1 [safe] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

[view] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

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Diphenylmethanes

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Diphenylmethanes

) ) [field_precautions] => Array ( [0] => Array ( [value] => The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity. A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately. Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients. Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated. Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed. Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended . [format] => 1 [safe] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

[view] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

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Category D

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Category D

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• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

[view] =>

• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

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• Store below 30 C°
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The primary site of action appears to be the motor cortex where spread of seizure activity is inhibited. Possibly by promoting sodium efflux from neurons, phenytoin tends to stabilize the threshold against hyperexcitability caused by excessive stimulation or environmental changes capable of reducing membrane sodium gradient. This includes the reduction of posttetanic potentiation at synapses. Loss of posttetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures.

[#title] => [#description] => [#printed] => 1 ) [field_pharmacokinetics] => Array ( [#type_name] => product [#context] => full [#field_name] => field_pharmacokinetics [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 4 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_pharmacokinetics [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL. Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19. A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels. When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms. [format] => 1 [safe] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

) [#title] => [#description] => [#children] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_pharmacokinetics [#title] => Pharmacokinetics [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

The plasma half-life in man after intravenous administration ranges from 10 to 15 hours. Optimum control without clinical signs of toxicity occurs most often with serum levels between 10 and 20 mcg/mL.

Phenytoin is metabolized by the cytochrome P450 enzymes CYP2C9 and CYP2C19.

A fall in plasma levels may occur when patients are changed from oral to intramuscular administration. The drop is caused by slower absorption, as compared to oral administration, due to the poor water solubility of phenytoin. Intravenous administration is the preferred route for producing rapid therapeutic serum levels.

When intramuscular administration may be required, a sufficient dose must be administered intramuscularly to maintain the plasma level within the therapeutic range. Where oral dosage is resumed following intramuscular usage, the oral dose should be properly adjusted to compensate for the slow, continuing IM absorption to avoid toxic symptoms.

[#printed] => 1 ) [#title] => [#description] => [#children] => [#printed] => 1 ) [field_indications] => Array ( [#type_name] => product [#context] => full [#field_name] => field_indications [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 5 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_indications [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery. [format] => 1 [safe] =>

control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

) [#title] => [#description] => [#children] =>

control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_indications [#title] => Indications [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

[#printed] => 1 ) [#title] => [#description] => [#children] => [#printed] => 1 ) [field_administration_and_dosage] => Array ( [#type_name] => product [#context] => full [#field_name] => field_administration_and_dosage [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 6 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_administration_and_dosage [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => [format] => [safe] => [#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => ) [#title] => [#description] => [#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_administration_and_dosage [#title] => Administration and Dosage [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#printed] => 1 ) [#title] => [#description] => [#printed] => 1 ) [field_contraindications] => Array ( [#type_name] => product [#context] => full [#field_name] => field_contraindications [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 7 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_contraindications [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins. Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors. [format] => 1 [safe] =>

those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

) [#title] => [#description] => [#children] =>

those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_contraindications [#title] => Contraindications [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

those patients with a history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins.
Coadministration of phenytoin is contraindicated with delavirdine due to potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhibitors.

[#printed] => 1 ) [#title] => [#description] => [#children] => [#printed] => 1 ) [field_precautions] => Array ( [#type_name] => product [#context] => full [#field_name] => field_precautions [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 8 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_precautions [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity. A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately. Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients. Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated. Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed. Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended . [format] => 1 [safe] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

) [#title] => [#description] => [#children] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_precautions [#title] => Precautions [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

The liver is the chief site of biotransformation of phenytoin; patients with impaired liver function, elderly patients, or those who are gravely ill may show early signs of toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown to metabolize the drug slowly. Slow metabolism may be due to limited enzyme availability and lack of induction; it appears to be genetically determined. If early signs of dose related CNS toxicity develop, plasma levels should be checked immediately.

Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes. Appropriate diagnostic procedures should be performed as indicated.
Phenytoin is not effective for absence (petit mal) seizures. If tonic-clonic (grand mal) and absence (petit mal) seizures are present, combined drug therapy is needed.

Serum levels of phenytoin sustained above the optimal range may produce confusional states referred to as “delirium,” “psychosis,” or “encephalopathy,” or rarely irreversible cerebellar dysfunction. Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction of phenytoin therapy is indicated if plasma levels are excessive; if symptoms persist, termination is recommended .

[#printed] => 1 ) [#title] => [#description] => [#children] => [#printed] => 1 ) [field_drug_interactions] => Array ( [#type_name] => product [#context] => full [#field_name] => field_drug_interactions [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 9 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_drug_interactions [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => • antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others); • an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others); • aspirin or other salicylates; • birth control pills or hormone replacement therapy; • a blood thinner such as warfarin (Coumadin); • certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine); • heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine; • prochlorperazine , promethazine ( Phenergan), and other phenothiazines; • steroid medicines (prednisone and others); • seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium); • stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or • theophylline [format] => 1 [safe] =>

• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

) [#title] => [#description] => [#children] =>

• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_drug_interactions [#title] => Drug Interactions [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

• antibiotics such as cycloserine (Seromycin), doxycycline ,isoniazid (for treating tuberculosis), linezolid (Zyvox), rifampin , or sulfa drugs (Bactrim, and others);
• an antidepressant (such as Amitriptiline, Bupivacaine, Doxepin, Nortriptyline, Paroxetine, Zoloft, Trazodone, and others);
• aspirin or other salicylates;
• birth control pills or hormone replacement therapy;
• a blood thinner such as warfarin (Coumadin);
• certain sedatives (chlordiazepoxide, Clidinium-C, Diazepam) or antidepressants (, Fluvaxamine, Fluoxetine);
• heart medication such as amiodarone (Cordarone,), digoxin (Lanoxin), furosemide (Lasix), or quinidine;
• prochlorperazine , promethazine ( Phenergan), and other phenothiazines;
• steroid medicines (prednisone and others);
• seizure medicine (such as Carbamazepine, Phenobarbital, Valproate sodium);
• stomach acid reducers (such az Cimetidine, Omeprazole, Ranitidine); or
• theophylline

[#printed] => 1 ) [#title] => [#description] => [#children] => [#printed] => 1 ) [field_side_effects] => Array ( [#type_name] => product [#context] => full [#field_name] => field_side_effects [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 10 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_side_effects [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => • fever, swollen glands, body aches, flu symptoms; • skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness; • upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes); • chest pain, irregular heart rhythm, feeling short of breath; • confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all; • new or worsening cough with fever, trouble breathing; • tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck; • patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Less serious phenytoin side effects may include: • slurred speech, loss of balance or coordination; • swollen or tender gums; or • headache, dizziness, nervousness, or sleep problems (insomnia). [format] => 1 [safe] =>

• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

) [#title] => [#description] => [#children] =>

• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_side_effects [#title] => Side Effects [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

• fever, swollen glands, body aches, flu symptoms;
• skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
• upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, feeling short of breath;
• confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;
• new or worsening cough with fever, trouble breathing;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight); or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Less serious phenytoin side effects may include:

• slurred speech, loss of balance or coordination;
• swollen or tender gums; or
• headache, dizziness, nervousness, or sleep problems (insomnia).

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The primary site of action appears to be the motor cortex where spread of seizure activity is inhibited. Possibly by promoting sodium efflux from neurons, phenytoin tends to stabilize the threshold against hyperexcitability caused by excessive stimulation or environmental changes capable of reducing membrane sodium gradient. This includes the reduction of posttetanic potentiation at synapses. Loss of posttetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures.

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