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2024 MAY 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Human Herpesvirus Diseases and Conditions - Epstein-Barr Virus [...]

Phenytoin was initially discovered in 1908 and has since become one of the most widely utilized and studied anticonvulsants. But with its widespread daily use and narrow therapeutic index (10-20 [...]

2018 OCT 6 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Nervous System Diseases and Conditions - Seizures have [...]

Phenytoin is an anticonvulsant whose main use is as a second line drug in treating generalised tonic-clonic seizures and sometimes other forms of epilepsy. It can be used either to [...]

Although pregnant women with hypertension are usually given magnesium sulfate to prevent seizures, it is possible that other anticonvulsants, such as phenytoin, would also be effective. To investigate this further, a prospective, controlled study was carried out with 47 hypertensive patients who are at 36 weeks or more gestation (70 percent were only mildly hypertensive). The subjects were randomly assigned to receive either magnesium sulfate (24 patients) or phenytoin (23 patients) intravenously; blood levels of the drugs were monitored. After delivery, patients and nurses completed questionnaires concerning the side effects of the drugs. The neonatal outcome was also evaluated. Results showed that both drugs were safe and tolerated well by the women. No seizures occurred and no negative neonatal outcomes were noted. The blood levels of free phenytoin (not bound to albumin) were within the therapeutic range in 22 cases, while the total phenytoin levels (free plus bound) were higher than the usual levels in nonpregnant patients. The results show that both phenytoin and magnesium sulfate are safe and effective for seizure prophylaxis. Because less patient monitoring is needed with phenytoin than magnesium sulfate, patients with mild pregnancy-induced hypertension and low risk of seizures may be better suited for phenytoin treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Initial Assessment When you assess vital signs in the pregnant patient, bear in mind the physiologic changes that accompany pregnancy (see Table 1, page 134). Evaluate the airway, breathing, and [...]

There is an increase in the prevalence of birth defects among the children of epileptic mothers; this prevalence has been attributed to the teratogenic effects of anticonvulsant drugs. Previous reports of defects in children born to women taking phenytoin (dilantin) have prompted the suggestion that some fetuses may be predisposed to the toxic effects of the drug because of some inborn error of metabolism. The recent case of a child born to a 28-year-old woman with epilepsy illustrates what may represent the extreme end of the spectrum of malformations caused by phenytoin. The seizures of the epileptic woman were successfully controlled with a daily dose of 175 milligrams of phenytoin and 1 gram sodium valproate. She had given birth to one healthy child. Her second pregnancy, however, required a caesarian section to give birth to a female infant, who was bluish and limp at birth. The child was successfully resuscitated, but developed convulsions at 10 minutes of age. The seizures continued, and at 66 hours of age intensive care was withdrawn and the infant died. Pathologic examination revealed an extremely small brain inside of an abnormally thick skull. The expected brain weight of a 2,860 gram infant would be about 310 grams; in this case the brain weighed 159 grams, just over half normal. The cerebellum was even more grossly affected. Instead of a normal 25 grams, the cerebellum of this infant weighed 2.8 grams. In retrospect, the mother reported abnormal rapid, rhythmical fetal movements, which were different from those experienced during her first pregnancy, suggesting that seizures might have occurred prenatally. It is well established that phenytoin can have toxic effects on the Purkinje cells of the cerebellum in some adults. This is the first report of seizures in an infant prenatally exposed to phenytoin, but numerous reports of brain abnormalities of similarly exposed infants have been reported. (Congenital neurological abnormalities have also been associated with sodium valproate, but neuropathology data is not available.) The wide variability in the results of prenatal exposure to phenytoin suggests that some individual variations in susceptibility are likely to be at work. (Consumer Summary produced by Reliance Medical Information, Inc.)

Eclampsia is a complication of pregnancy marked by maternal high blood pressure, swelling, protein in the urine and convulsions. The mechanisms behind eclampsia and preeclampsia (a similar condition but unaccompanied by convulsions) are not well known, treatment is aimed at reducing blood pressure with antihypertensive agents, controlling seizures with anticonvulsive agents, increasing fluid and prompt delivery. Currently, magnesium sulphate is the anticonvulsant of choice. However, this compound is rapidly eliminated from the body, making large doses of the drug necessary to maintain effectiveness. Phenytoin is an anticonvulsant used to treat epilepsy. The relative effectiveness of phenytoin and magnesium sulphate was compared in 22 similarly-matched patients with eclampsia. No side effects were experienced during therapy achieving therapeutic doses (between 1.25 and 2.5 millimoles per liter of magnesium sulphate and 40-100 micromoles per liter of phenytoin). None of the 11 patients receiving magnesium sulphate had recurrent convulsions, while four out of 11 patients treated with phenytoin had repeated seizures. Therefore, phenytoin was not as effective as magnesium sulphate in preventing recurrent seizures in patients with eclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objective: Phenytoin, a classical anticonvulsant, shares with antimanic anticonvulsants the property of blockade of voltage-activated sodium channels. The authors therefore planned a trial of phenytoin for mania. Method: Patients with either bipolar I disorder, manic type, or schizoaffective disorder, manic type, entered a 5-week, double-blind controlled trial of haloperidol plus phenytoin versus haloperidol plus placebo. Of 39 patients, 30 completed at least 3 weeks and 25 completed 5 weeks. Results: Significantly more improvement was observed in the patients receiving phenytoin. Added improvement with phenytoin in scores on the Brief Psychiatric Rating Scale and Clinical Global Impression was seen in the patients with bipolar mania but not those with schizoaffective mania. Conclusions: Blockade of voltage-activated sodium channels may be a common therapeutic mechanism of many anticonvulsants given for mania, and phenytoin may be a therapeutic option for some manic patients.

Free serum phenytoin level test is used to assess phenytoil levels, which determines the amount of unbound drug in the bloodstream and this is one of the expensive tests. Phenytoin is 90% protein bound and only the free fraction circulating in plasma is biologically active and available to cross the blood-brain barrier and prevent seizures.

Diphenylhydantoin (phenytoin; dilantin) is a drug used in the treatment of seizure disorders. The effectiveness of phenytoin therapy in the prevention and treatment of seizures that occur during alcohol withdrawal is controversial. Although the seizures of alcohol withdrawal are self-limiting, anticonvulsant medication is helpful in the short-term management of patients with a history of alcohol withdrawal seizures. Ninety alcoholic patients experienced a seizure during alcohol withdrawal. Phenytoin was given to 45 of the patients within six hours of a seizure; the other 45 patients received a placebo drug. Other drugs known to lower the seizure threshold (increase vulnerability to having a seizure) were removed. In both groups, six patients had a recurrent seizure. The use of phenytoin offered no additional seizure protection over the placebo. Since intravenous phenytoin administration can cause reactions at the injection site, low blood pressure, abnormal heart beats and (rarely) sudden death, the risks of administering phenytoin to alcoholic patients for the treatment and prevention of alcohol withdrawal seizures exceed any potential benefit. Barbiturates, long-acting benzodiazepines, or calcium channel antagonists may offer improved seizure control for these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

The Food and Drug Administration is investigating preliminary data indicating that people with the human leukocyte antigen (HLA) allele HLA-B*1052 may be at greater risk of developing Stevens-Johnson syndrome (SJS) [...]

Fosphenytoin is a phosphate ester pro-drug of phenytoin that is rapidly converted in plasma to phenytoin. Its safety profile and ease of use make it an attractive drug for the [...]