Phenytoin: The Anticonvulsant for Epilepsy and Seizures
What is Phenytoin?
Phenytoin is an anticonvulsant medication indicated in epilepsy and to prevent seizures. It stabilizes the electrical activity in the brain by inhibiting excessive neuronal firing, making it effective for a variety of seizure types.
How Phenytoin Works
Phenytoin works by stabilizing the neuronal membranes and inhibiting sodium ion influx into neurons, which reduces the likelihood of abnormal electrical discharges that cause seizures.
When to Use Phenytoin
● Epilepsy: Phenytoin is used to control generalized tonic-clonic seizures and partial seizures.
● Status Epilepticus: It is used intravenously to treat acute status epilepticus (a life-threatening, continuous seizure).
Dosage
● Adult Dose for Seizures: The initial dose is typically 100 mg to 200 mg orally, 3 times a day, with gradual adjustments based on response. For status epilepticus the loading dose is 15-20 mg/kg and then maintenance is started after 12 hours of loading dose. Maximum dose is 2 gram/day.
● Pediatric Dose: Dosing is based on weight and for status epilepticus the loading dose starts at 15-20 mg/kg and then maintenance is started after 12 hours of loading dose.
Side Effects
● Common Effects: Dizziness, headache, nausea, and gum overgrowth (gingival hyperplasia).
● Serious Adverse Effects: Hepatotoxicity, blood disorders (e.g., leukopenia), and suicidal thoughts.
Common brands: Eptoin,Epsolin.
