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Fosphenytoin: profile and news
Epilepsy drug offers advantages 08 Sep 2005 Exposed Nerve Apr 6, 2005 Tapestry Reports Fourth Quarter and Full Year 2004 Results Feb 23, 2005 Other information Indication For the control of generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery Pharmacology Phenytoin is an antiepileptic drug which can be useful in the treatment of epilepsy. The primary site of action appears to be the motor cortex where spread of seizure activity is inhibited. Possibly by promoting sodium efflux from neurons, Phenytoin tends to stabilize the threshold against hyperexcitability caused by excessive stimulation or environmental changes capable of reducing membrane sodium gradient. This includes the reduction of post-tetanic potentiation at synapses. Loss of post-tetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures. Mechanism Of Action Phenytoin acts on sodium channels on the neuronal cell membrane, limiting the spread of seizure activity and reducing seizure propagation. The antiarrhythmic actions are mediated through effects on sodium channels in Purkinje fibers. Drug Category Anticonvulsants; Hydantoins; ATC:N03AB02; ATC:N03AB04; ATC:N03AB05 Brand Names/Synonyms Aleviatin; Antisacer; Auranile; CCRIS 515; Causoin; Cerebyx; Citrullamon; Citrulliamon; Comital; Comitoina; Convul; DPH; Danten; Dantinal; Dantoinal; Dantoinal Klinos; Dantoine; Denyl; Di-Hydan; Di-Lan; Di-Phetine; Didan Tdc 250; Difenilhidantoina; Difenilhidantoina [Spanish]; Difenin; Difetoin; Difhydan; Dihycon; Dihydantoin; Dilabid; Dilantin; Dilantin Acid; Dilantin-125; Dilantine; Dillantin; Dintoin; Dintoina; Diphantoin; Diphantoine; Diphedal; Diphedan; Diphenat; Diphenin; Diphenine; Diphentoin; Diphentyn; Diphenylan; Diphenylan Sodium; Diphenylhydantoin; Diphenylhydantoine; Diphenylhydantoine [French]; Diphenylhydatanoin; Ditoinate; Ekko; Ekko Capsules; Elepsindon; Enkelfel; Epamin; Epanutin; Epasmir "5"; Epasmir &Quot;5&Quot;; Epasmir 5; Epdantoin Simple; Epdantoine Simple; Epelin; Epifenyl; Epihydan; Epilan; Epilan D; Epilan-D; Epilantin; Epinat; Epised; Eptal; Eptoin; Extended Phenytoin Sodium; Fenantoin; Fenantoin Mn Pharma; Fenidantoin "S"; Fenidantoin &Quot;S&Quot;; Fenidantoin S; Fenitoina; Fenitoina [Inn-Spanish]; Fentoin; Fenylepsin; Fenytoin Dak; Fenytoine; Fosphenytoin; Hidan; Hidantal; Hidantilo; Hidantina; Hidantina Senosian; Hidantina Vitoria; Hidantomin; Hindatal; Hydantal; Hydantin; Hydantoin; Hydantoinal; Hydantol; Ictalis Simple; Idantoil; Idantoin; Iphenylhydantoin; Kessodanten; Labopal; Lehydan; Lepitoin; Lepsin; Mesantoin; Minetoin; NSC 8722; Neos-Hidantoina; Neosidantoina; Novantoina; Novophenytoin; Om Hidantoina Simple; Om-Hydantoine; Oxylan; Phanantin; Phanatine; Phenatine; Phenatoine; Phenhydan; Phenhydanin; Phenitoin; Phentoin; Phentytoin; Phenytex; Phenytoin; Phenytoin Awd; Phenytoin Sodium; Phenytoin-Gerot; Phenytoine; Phenytoine [Inn-French]; Phenytoinum [Inn-Latin]; Prompt Phenytoin Sodium; Ritmenal; Saceril; Sanepil; Silantin; Sinergina; Sodanthon; Sodantoin; Sodanton; Sodium; Solantin; Solantoin; Solantyl; Sylantoic; TOIN; Tacosal; Thilophenyl; Toin Unicelles; Zentronal; Zentropil Dosage Forms CAPSULE; LIQUID; SOLUTION; SUSPENSION; TABLET Absorption Not Available Interactions -->Interactions for Phenytoin: There are many drugs which may increase or decrease phenytoin levels or which phenytoin may affect. Serum level determinations for phenytoin are especially helpful when possible drug interactions are suspected. The most commonly occurring drug interactions are listed below: 1. Drugs which may increase phenytoin serum levels include: acute alcohol intake, amiodarone, chloramphenicol, chlordiazepoxide, diazepam, dicumarol, disulfiram, estrogens, H2-antagonists, halothane, isoniazid, methylphenidate, phenothiazines, phenylbutazone, salicylates, succinimides, sulfonamides, tolbutamide, trazodone. 2. Drugs which may decrease phenytoin serum levels include: carbamazepine, chronic alcohol abuse, reserpine, and sucralfate. Moban brand of Molindone Hydrochloride contains calcium ions which interfere with the absorption of phenytoin. Ingestion times of phenytoin and antacid preparations containing calcium should be staggered in patients with low serum phenytoin levels to prevent absorption problems. 3. Drugs which may either increase or decrease phenytoin serum levels include: phenobarbital, sodium valproate, and valproic acid. Similarly, the effect of phenytoin on phenobarbital, valproic acid and sodium valproate serum levels is unpredictable. 4. Although not a true drug interaction, tricyclic antidepressants may precipitate seizures in susceptible patients and phenytoin dosage may need to be adjusted. 5. Drugs whose efficacy is impaired by phenytoin include: corticosteroids, coumarin anticoagulants, digitoxin, doxycycline, estrogens, furosemide, oral contraceptives, quinidine, rifampin, theophylline, vitamin D. Drug/Laboratory Test Interactions Phenytoin may cause decreased serum levels of protein-bound iodine (PBI). It may also produce lower than normal values for dexamethasone or metyrapone tests. Phenytoin may cause increased serum levels of glucose, alkaline phosphatase, and gamma glutamyl transpeptidase (GGT). Chemical IUPAC Name 5,5-diphenylimidazolidine-2,4-dione Chemical Formula C15H12N2O2 Half Life 22 hours Drug Type Approved Drug # Accession No APRD00241 CAS Registry Number 57-41-0 |
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