Scribd Logo
Upload

Welcome to Scribd!

  • 38 views

    Dilantin

    Uploaded by

    Phil Bob
    Dilantin/Phenytoin is an anticonvulsant and antiarrhythmic drug classified as Pregnancy Category D. It is used to treat seizures, status epilepticus, and cardiac dysrhythmias. Dilantin can be administered intravenously, intramuscularly, or orally with dosages varying based on age, weight, liver and kidney function, obesity, and pregnancy status. Dilantin has drug interactions with alcohol, other CNS depressants, antifungals, glucocorticoids, and local anesthetics that can increase its effects or decrease its efficacy. Gingival hyperplasia is a common side effect that requires good oral hygiene.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Dilantin

    Uploaded by

    Phil Bob
    38 views5 pages
    Dilantin/Phenytoin is an anticonvulsant and antiarrhythmic drug classified as Pregnancy Category D. It is used to treat seizures, status epilepticus, and cardiac dysrhythmias. Dilantin can be administered intravenously, intramuscularly, or orally with dosages varying based on age, weight, liver and kidney function, obesity, and pregnancy status. Dilantin has drug interactions with alcohol, other CNS depressants, antifungals, glucocorticoids, and local anesthetics that can increase its effects or decrease its efficacy. Gingival hyperplasia is a common side effect that requires good oral hygiene.

    Original Description:

    good

    Original Title

    Dilantin (1)

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Dilantin/Phenytoin is an anticonvulsant and antiarrhythmic drug classified as Pregnancy Category D. It is used to treat seizures, status epilepticus, and cardiac dysrhythmias. Dilantin can be administered intravenously, intramuscularly, or orally with dosages varying based on age, weight, liver and kidney function, obesity, and pregnancy status. Dilantin has drug interactions with alcohol, other CNS depressants, antifungals, glucocorticoids, and local anesthetics that can increase its effects or decrease its efficacy. Gingival hyperplasia is a common side effect that requires good oral hygiene.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    38 views5 pages

    Dilantin

    Uploaded by

    Phil Bob
    Dilantin/Phenytoin is an anticonvulsant and antiarrhythmic drug classified as Pregnancy Category D. It is used to treat seizures, status epilepticus, and cardiac dysrhythmias. Dilantin can be administered intravenously, intramuscularly, or orally with dosages varying based on age, weight, liver and kidney function, obesity, and pregnancy status. Dilantin has drug interactions with alcohol, other CNS depressants, antifungals, glucocorticoids, and local anesthetics that can increase its effects or decrease its efficacy. Gingival hyperplasia is a common side effect that requires good oral hygiene.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    Dilantin/ Phenytoin

    Pregnancy risk Category: D

    Drug class: Anticonvulsant, hydantoin, antiarrhythmic

    INDICATIONS AND DOSAGES


    IV
    Adults, Elderly.
    Status epilepticus: Loading dose: 10– 15 mg/kg;
    Maintenance dose: 300 mg/day or 4– 6 mg/kg/day in 2– 3
    divided doses.
    Cardiac dysrhythmia: 1.25 mg/kg every 5 min as needed. May
    repeat to a max dose of 15 mg/kg.
    IM
    Seizure, during and following neurosurgery; treatment and
    prophylaxis: 100– 200 mg IM every 4 hr during surgery and
    continued during the postoperative period.
    PO
    Adults, Elderly. Seizure control: Loading dose: 15– 20 mg/kg in
    3 divided doses 2– 4 hr apart. Maintenance dose: 300 mg/day
    or 4– 6 mg/kg/day in 2– 3 divided doses.

    Status Epilepticus
    IV
    Children 10– 16 yr. 6– 7 mg/kg/day.
    Children 7– 9 yr. 7– 8 mg/kg/day.
    Children 4– 6 yr. 7.5– 9 mg/kg/day.
    Children 6 mo– 3 yr. 8– 10 mg/kg/ day.
    Neonates. Loading dose: 15– 20 mg/ kg; Maintenance dose: 5–
    8 mg/kg/ day. PO
    Seizure control: Loading dose: 15– 20 mg/kg in 3 divided
    doses 2– 4 hr apart. Maintenance dose: 300 mg/day or 4– 6
    mg/kg/day in 2– 3 divided doses.

    Dosage adjustments
    Dosage adjustments may be required in the elderly: Initially, 3
    mg/kg/day, in divided doses, the dosage being adjusted
    according to serum hydantoin concentrations and patient
    response.
    Obese patients: the IV loading dose should be calculated on the
    basis of ideal body weight plus 1.33 times the excess weight
    over ideal weight, because phenytoin preferentially distributes
    into fat.
    Pregnancy: phenytoin requirements are greater during
    pregnancy, requiring increases in doses in some patients. After
    delivery, the dose should be decreased to avoid toxicity.
    Liver disease: there may be an increase in unbound phenytoin
    concentrations in patients with hepatic insufficiency,
    recommended to measuring unbound phenytoin
    concentrations level.
    Renal impairment: there may be an increase in unbound
    phenytoin concentrations in patients with renal impairment,
    recommended to measuring unbound phenytoin
    concentrations level.
    DRUG INTERACTIONS OF CONCERN TO DENTISTRY • • •
    •Alcohol, other CNS depressants: May increase CNS depression.
    • Fluconazole, ketoconazole, miconazole: May increase
    phenytoin blood concentration.
    • Glucocorticoids: Phenytoin may decrease the effects of
    glucocorticoids.
    • Lidocaine, propranolol: Phenytoin may increase cardiac
    depressant effects.
    Local Anesthetic/Vasoconstrictor Precautions: No
    information available to require special precautions

    Effects on Dental Treatment: Gingival hyperplasia is a common


    problem observed during the first 6 months of phenytoin therapy appearing
    as gingivitis or gum inflammation. To minimize severity and growth rate of
    gingival tissue begin a program of professional cleaning and patient plaque
    control within 10 days of starting anticonvulsant therapy.

    Effects on Bleeding: No information available to require special


    precautions

    Pregnancy Considerations: Phenytoin crosses the placenta


    (Harden and Pennell 2009). An increased risk of congenital malformations
    and adverse outcomes may occur following in utero phenytoin exposure.
    Reported malformations include orofacial clefts, cardiac defects,
    dysmorphic facial features, nail/digit hypoplasia, growth abnormalities
    including microcephaly, and mental deficiency. Isolated cases of
    malignancies (including neuroblastoma) and coagulation defects in the
    neonate (may be life threatening) following delivery have also been
    reported.

    References:
    http://www.slideshare.net/ess_online/seizures-lecture
    Mosby dental drug reference
    Lexicomp

    You might also like