Antiepileptic Drugs Question And Answers

Antiepileptic Drugs Question And Answers

Write Short Notes On Phenytoin. And It’s Pharmacological Action And Adverse Effects. Classify Anti­Epileptic Drugs.
Answer:

Phenytoin is a diphenylhydantoin.

“Understanding the role of antiepileptic drugs in treating epilepsy”

Antiepileptic Drugs: Mechanism of Action and Clinical Uses

Phenytoin Mechanism Of Action

Phenytoin stabilizes the neuronal membrane and prevents the spread of seizure discharge. Phenytoin delays the recovery of sodium ion channels from inactivated state and decreases the excitability of neurons.

At its high concentration phenytoin stop calcium ion influx in neuron and decreases glutamate levels and enhances response to GABA.

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Phenytoin Pharmacological Actions

• CNS actions: It has antiepileptic actions without causing drowsiness or sedation. It is not a CNS depressant.
• CVS: It has a membrane-stabilizing effect.
• At higher doses, it shows zero order kinetics.
• It induces hepatic microsomal enzymes.

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Phenytoin Adverse Reactions or Phenytoin Side Effects

1. Phenytoin leads to dose-dependent toxicity which leads to the following side effects:

• Hyperplasia and hypertrophy of gums.
• Hypersensitivity reaction, i.e. urticaria, rashes, and lymphadenopathy.
• Hirsutism, acne, and coarsening of facial features.
• Hyperglycemia can occur due to decreased secretion of insulin.
• Hypocalcemia occurs due to decreased absorption of calcium from the gut.
• Megaloblastic anemia can occur due to folate deficiency.
• Osteomalacia occurs due to an increase in the metabolism of vitamin D.
• Fetal hydantoin syndrome occurs when used in pregnancy.

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2. In high concentration phenytoin can lead to:

• CNS: On chronic therapy, the vestibulocerebellar syndrome can occur.
• CVS: On IV administration it may cause hypotension and cardiac arrhythmias.
• GIT: Nausea, vomiting, and dyspepsia.

Phenytoin Uses

• Phenytoin is used in grand mal epilepsy.
• It is used in partial epilepsy.
• It is used in status epilepticus, trigeminal neuralgia, and cardiac arrhythmia.

Common Antiepileptic Drugs: Phenytoin, Valproate, Carbamazepine, and More

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Phenytoin Drug Interaction

• Phenobarbitone inhibits phenytoin metabolism.
• Phenytoin increases the degradation of digitoxin, folate, and oral contraceptive.