What are the major adverse effects of phenytoin?
Phenytoin is used to control certain type of seizures, and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. Phenytoin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain. Show
How should this medicine be used?Phenytoin comes as an extended-release (long-acting) capsule, a chewable tablet, and a suspension (liquid) to take by mouth. The chewable tablet and suspension are usually taken two or three times a day. The extended-release capsules are usually taken one to four times a day. Take phenytoin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take phenytoin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will start you on a low dose of phenytoin and gradually increase your dose, not more often than once every 7 to 10 days. Different phenytoin products are absorbed by the body in different ways and cannot be substituted for one another. If you need to switch from one phenytoin product to another, your doctor may need to adjust your dose. Each time you receive your medication, check to be sure that you have received the phenytoin product that was prescribed for you. Ask your pharmacist if you are not sure that you received the right medication. Shake the liquid well before each use to mix the medication evenly. Use an accurate measuring device to be sure you receive the correct amount of medication. Ask your doctor or pharmacist if you have any questions about how to measure your dose. Swallow the extended-release capsules whole; do not split, chew, or crush them. Do not take capsules that are discolored. You may chew the chewable tablets thoroughly before swallowing them, or you may swallow them whole without chewing. If you are receiving formula or supplements through a feeding tube, talk to your doctor about when you should take phenytoin. You will need to allow some time between receiving your feedings and taking phenytoin. Phenytoin may help control your condition but will not cure it. Continue to take phenytoin even if you feel well. Do not stop taking phenytoin without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking phenytoin, your seizures may worsen. Your doctor will probably decrease your dose gradually. Other uses for this medicinePhenytoin is also used to control irregular heartbeat. Talk to your doctor about the risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. What special precautions should I follow?Before taking phenytoin,
What special dietary instructions should I follow?Unless your doctor tells you otherwise, continue your normal diet. What should I do if I forget a dose?Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. What side effects can this medication cause?Phenytoin may cause an increase in your blood sugar. Talk to your doctor about the symptoms of high blood sugar and what to do if you experience these symptoms.Phenytoin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of the following symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately:.
Some side effects can be serious. If you experience any of the following symptoms, stop taking phenytoin and call your doctor:
Phenytoin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Taking phenytoin may increase the risk that you will develop osteopenia, osteoporosis, or osteomalacia and problems with your lymph nodes including Hodgkin's disease (cancer that begins in the lymph system). Talk to your doctor about the risks of using this medication to treat your condition. What should I know about storage and disposal of this medication?Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from light and excess heat and moisture (not in the bathroom). Do not freeze the liquid. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. In case of emergency/overdoseIn case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Symptoms of overdose may include the following:
What other information should I know?Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to phenytoin. Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking phenytoin. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Which of the following adverse effects may occur during phenytoin therapy?These symptoms may include, but are not limited to, fever, sore throat, rash, ulcers in the mouth, easy bruising, lymphadenopathy, facial swelling, and petechial or purpuric hemorrhage, and in the case of liver reactions, anorexia, nausea/vomiting, or jaundice.
What is the major concern after administering phenytoin to a patient with seizure?Overdose on oral phenytoin mainly causes neurotoxicity, whereas cardiovascular toxicity is the main side effect of parenteral administration. The neurotoxic effects are concentration-dependent and can range from mild nystagmus to ataxia, slurred speech, vomiting, lethargy, and eventually coma and death.
What are the adverse effects of phenytoin and what does the nurse need to monitor for?Adverse effects
Hypersensitivity, lack of appetite, headache, dizziness, tremor, transient nervousness, insomnia, GI disturbances (e.g. nausea, vomiting, constipation), tenderness and hyperplasia of the gums, acne, hirsutism, coarsening of the facial features, rashes, osteomalacia.
What are signs of phenytoin toxicity?They may include:. Confusion.. Staggering gait or walk (early sign). Unsteadiness, uncoordinated movements (early sign). Involuntary, jerky, repeated movement of the eyeballs called nystagmus (early sign). Seizures.. Tremor (uncontrollable, repeated shaking of the arms or legs). Sleepiness.. |