Brand Name: Dilantin Generic Name: Phenytoin Indication: Dilantin is Indicated

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Brand name: DilantinGeneric name:

Phenytoin

Indication:

Dilantin is indicated for the control of tonic-clonic ( grand mal) and psychomotor( temporal lobe) seizures.

Drug Classification:

Therapeutic category: Anticonvulsants, Hydantoin, Anti-arrhythmic

Mechanism of Action:

Decreases seizure activity by increasing efflux or decreasinginflux of sodium ions across cell membranes in the motor cortex duringgeneration of nerve impulses; prolongs effective refractory period andsuppresses ventricular pacemaker automaticity , shortens action potential in theheart.

Dosage:

Adults and elderly:

Status epilepticus: IV: loading dose:15-20 mg/kg in a single or divided dose,followed by 100-150 mg/dose at 30-minute intervals up to a maximum of 1500mg/24 hours;Maintenance dose: 300 mg/day or 5-6 mg/kg/day in 3 divided doses or 1-2divided doses using extended release.

Anticonvulsant: oral: loading dose: 15-20 mg/kg; based on phenytoin serumconcentrations and recent dosing history; administer oral loading dose in 3divided doses given every 2-4 hours to decrease GI adverse effects

Special Precaution:

May increase frequency of petit mal seizures. I.V. form may causehypotension, , skin necrosis at IV site. Avoid IV administration in small veins.Use with caution in patients with porphyria. Discontinue if rash or lymphadenopathy occurs. Use with caution in patients with hepatic dysfunction,sinus bradycardia, S-A block, A-V block, or hepatic impairment. Elderly mayhave reduced hepatic clearance and low albumin levels, which will increase thefree fraction of phenytoin in the serum and increase drug response

Pregnancy risk category DAdverse Effects:

If you experience any of the following serious side effects, stop taking phenytoin and seek emergency medical attention or contact your doctor immediately: an allergic reaction (difficulty breathing; closing of the throat;swelling of the lips, tongue, or face; or hives), hallucinations, slurred speech or staggering walk, a rash, changes in vision, agitation, low blood pressure, slow or irregular heartbeats, abdominal pain, dark urine, light colored stools, or jaundice

(continuation Dilantin)

(yellow skin or eyes), easy bruising or bleeding or swollen or tender gums.nausea, vomiting, constipation, or diarrhea, mild dizziness or drowsiness, tender or swollen glands, swollen or painful gums, headache, muscle twitches,increased facial hair, swelling of breasts, or insomnia.

Contraindication:

Hypersensitivity to phenytoin, other hydantoins, or any component;heart block; sinus bradycardia

Form:

capsule, tablet( precision released, time released)

Nursing Responsibilities:

Obtain data relating to the six cardinal signs of cardiovascular disease to be used as a baseline for subsequent evaluation of response therapy.Record date relating to any GI symptoms present before initiation of therapy.Assess and record data relating to the patient’s mental status ( e.g. orientation,agitation, confusion).Phenytoin is a Pregnancy risk factor D- Assess knowledge/teach appropriate useof barrier contraceptives (phenytoin may interfere with effectiveness of oralcontraceptives). Instruct patient to take this drug as directed, with food; tofollow good oral hygiene practices; monitor serum glucose regularly as

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