Question

Search for Phenytoin information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

Answer 1

Answer:

Phenytoin

Generic name: Phenytoin

Brand name: Dilantin, Phenytek, Epanutin

Type of drug: Anticonvulsant

Pregnancy category: US FDA preagnacy category D ( due to risk for fetus)

Therapeutic action: prevent and control seizure

Indication: grandmal seizure, partial seizure, to prevent and treat seizure following neurosurgey.

Contraindication:diabetis, osteomalacia,myasthenia gravis, pancytopenia,alcoholism,systemic lupus erythmatous, wsollen lymph nodes, pregnancy,acute decompensated heart failure, liver disease, decreased kidney fuction.

Dose Adult :

Usual adult dose in seizure: loading dose 10-15mg/kg iv slowly.maintance dose 100mg iv every 6-8 hours.

Anticonvaulsant: tablet: 100mg PO TID, maintance dose 300-400mg/day.

Suspension: 125mg PO TID, increase to 625mg/day if needed.

Neurosurgery: 100-200mg IM / IV at 4 hours intervals during surgery.100mg TID in post operative period.

Dose pediatric:

   Usual dose in seizure: loading dose 15-20mg/kg iv slowly in single or divided doses( same dose can be given in oral but should be in 3 divided dose in every 2-4 hours).maintance dose 5-8mg/kg/day according to age.   

Adverse effects: headache, nausea, vomiting,chest pain, slow heart rate, mouth sre, swollen gums,skin rashes, drowsiness, ataxia, nystagmus, slurred speech, confusion.hypersensitivity, hyperglycemia, hepatic injury,hematopoetic complications, renal and hepatic impairement.

Interactions:

Drugs that may increase the phenytoin level: ceratain antiepileptic drugs such as ethosuximide,oxcarbazipine. Azoles such as ketoconazole,miconazole etc,antineoplastic agents, antidepressant, sulfonamydes, omeprazole etc.

Drugs that may decrease the phenytoin level: certain antineoplastic agent, anti epileptic drugs, antacids, antiviral agents .

Drugs affected by phenytoin: certain calcium channel blockers,neuromuscular blocking agents, warfarin, antilipidemic agents, delaviridine.   

Nursing consideration: continuously monitor patient's cardiac rhythm and blood pressure during infusion.administer iv slowly to prevent hypotension.monitor the injection site (phenytoin is very alkeline and it irritates vein). Monitor for seum levels. Monitor blood sugar for diabetes.discontinue medication if there is any hypersensitivity reaction.provide oral hygiene for chronic patient to prevent gum hyperplasia.

patient education:

Keep out of reach of children

donot stop medication without discussing with the doctor

inform the side effects to the patient and ask to immediately contact the doctor if you feel any side effects including suicidal thoughts.

Before seeking any treatment for other diseases, inform the doctor that you are taking phenytion.

Avoid alcohol consuption