Generic Name and Brand Name

Classification

Action

Dosage

Indication

Contraindication

Adverse Effects

Nursing Responsibility

Generic Name: Phenytoin Brand names:

Dilantin-125, Dilantin Infatab, Dilantin Injection, Dilantin Kapseals, Diphenylan (CAN), Phenytek, Phenytex (CAN)

Antiepileptic agent, Hydantoin

Has antiepileptic activity without causing general CNS depression; stabilizes neuronal membranes and prevents hyperexcitability caused by excessive stimulation; limits the spread of seizure activity from an active focus; also effective in treating cardiac arrhythmias, especially those induced by digitalis; antiarrhythmic properties are very similar to those of lidocaine; both are class IB

Take with food Adult initially 100mg 3x per day Maintenance: 300-400mg daily.

Control of grand mal (tonic-clonic) and psychomotor seizures

Contraindicated with hypersensitivity to hydantoins, sinus bradycardia, Prevention sinoatrial and treatment block, Stokesof seizures Adams occurring syndrome, during or pregnancy following (data suggest neurosurgery an association between Control of antiepileptic status drug use and an epilepticus of elevated the grand mal incidence of type birth defects; (parenteral however, do administration) not discontinue antiepileptic Unlabeled therapy in uses: pregnant antiarrhythmic, women who are particularly in receiving such digitalistherapy to

Nystagmus, ataxia, dysarthria, slurred speech, mental confusion, dizziness, drowsiness, insomnia, transient nervousness, motor twitchings, fatigue, irritability, depression, numbness, tremor, headache, photophobia, diplopia, conjunctivitis

- Use only clear parenteral solutions. Do not use solutions that have haziness or a precipitate. -Administer IV slowly to prevent severe hypotension and irritating. -Monitor for therapeutic serum levels of 1020 mcg/mL. - Give oral drug with food to enhance absorption and to reduce GI upset.

Dermatologic reactions, scarlatiniform, morbilliform, - Recommend maculopapular, that the oral

antiarrhythmics.

induced arrhythmias (IV preparations); treatment of trigeminal neuralgia (tic douloureux)

prevent major seizures; this is likely to precipitate status epilepticus, with attendant hypoxia and risk to both mother and fetus), lactation.

urticarial and nonspecific rashes; serious and sometimes fatal dermatologic reactions-bullous, exfoliative, or purpuric dermatitis, lupus erythematosus, and StevensJohnson syndrome, toxic epidermal necrolysis, hirsutism, alopecia, coarsening of the facial features, enlargement of the lips, Peyronie's disease

phenytoin prescription be filled with the same brand each time; differences in bioavailability have been documented. Discontinue drug if rash, depression of blood count, enlarged lymph nodes, hypersensitivity reaction, signs of liver damage, or Peyronie's disease Monitor hepatic function periodically during longterm therapy; monitor blood counts, urinalysis

monthly. Monitor blood or urine sugar of patients with diabetes mellitus regularly.. Monitor blood proteins to detect early malfunction of the immune system (eg, multiple myeloma). Arrange dental instruction in proper oral hygiene technique for long-term patients to prevent development of gum hyperplasia