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

Brand name: Dilantin Generic 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, Antiarrhythmic Mechanism of Action: Decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses; prolongs effective refractory period and suppresses ventricular pacemaker automaticity , shortens action potential in the heart. 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 1-2 divided doses using extended release.

Anticonvulsant: oral: loading dose: 15-20 mg/kg; based on phenytoin serum concentrations and recent dosing history; administer oral loading dose in 3 divided doses given every 2-4 hours to decrease GI adverse effects Special Precaution: May increase frequency of petit mal seizures. I.V. form may cause hypotension, , 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 may have reduced hepatic clearance and low albumin levels, which will increase the free fraction of phenytoin in the serum and increase drug response Pregnancy risk category D Adverse 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 use of barrier contraceptives (phenytoin may interfere with effectiveness of oral contraceptives). Instruct patient to take this drug as directed, with food; to follow good oral hygiene practices; monitor serum glucose regularly as

prescribed if patient is diabetic; if GI upset occurs, frequent small meals may help; be cautious in engaging in hazardous tasks; report difficulty of breathing, rash, unresolved nausea or vomiting, slurring speech, swollen glands, bleeding gums, yellowish color to skin or eyes, palpitations.

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