In this study, we aimed to review the studies which evaluated the safety of phenytoin with respect to cardiovascular adverse effects. As the key words, "phenytoin, diphenylhydantoin, epilepsy, seizure, cardiac toxicity, asystole, arrhythmia, dilantin and heart rate, respiratory arrest, hypotension, death" were used. Thirty-two clinical trials and ten dilantin and heart rate reports were identified. In contrast, no serious cardiovascular adverse effects leading to death were met in the clinical trials which applied the recommended infusion rate and dosages.
For old patients and patients with a cardiovascular co-morbidity, a slower infusion rate was recommended with a careful follow-up of heart rhythm and blood pressure. No cardiovascular adverse effect was reported in oral phenytoin overdoses except one case with a very high serum phenytoin level and hypoalbuminemia. Phenytoin is an effective and well tolerated drug in the treatment of epilepsy. Intravenous phenytoin is safe when given at recommended infusion dilantin and heart rate and doses.
Figures - uploaded by Soheyl Noachtar. Cardiovascular adverse effects of phenytoin. Abstract Phenytoin is an established drug in the treat. One of its main advantages over benzodiazepines is the less. Howeve r, the possibility of cardiovascular. In this study, we aimed to. In contrast, no serious cardiovascular adver se effects. For old patients and patients with a car. No cardiovascular adverse effect was.
Phenytoin is an effect ive and well tolerated drug in the. Intravenous phenytoin is safe when. Phe nyto in wa s in trod uc ed as an epilep tic drug in 19 38 an d. Curr en tly, it s us age as anti ar rhyt hm ic pu rpos e is aban do ned. Phen ytoi n is one of. More ov er, th e. The se unf avor ab le repo rt s caus e a hesi ta tion in th e. The reco mmen de d slowed i nfus io n. Mean whi ledilantin and heart rate, th e new antiep il ept ic drugs with less car di ac. Here, dilantin and heart rate, we review the safety of IV phenytoi n adminis.
Department of Neurology, Epilepsy Center, University of. Phenytoin is effective in the treatment of partia l-onset and. The major mechanism of action of phenytoin is on the. Phenytoin blocks membrane channe ls, dilantin and heart rate. The oral and parenteral forms of phenytoin.
Without a loading dose, phenytoin can reach sta ble doses. Th e therapeutic serum levels can be rapidly. Due to the poor water. The major part of the phenytoin. Medications that inhibit these enzymes antimi crobials. Miconazole, and Sulfaphen azole, antidepressants such as. Fluoxetine, Fluvoxamine, Imipramine, Sertraline, Tra. The induc ed phenytoin toxicity.
The effect of phenytoin on the cardiovascular system. Phenytoin is dilantin and heart rate class IB antiarrhythmic drug. With thes e prop. Phenytoin can also cause a lowering. It is known that. Fosphenytoin, a pro-drug of. English lang uage betwee n the dates of — The obta ined publications were.
The number of dilantin and heart rate, diagnosis, primary end points. The neurological, gastrointestinal and derm atologic side. As the result of database search, 32 c linical trials and ten case. Three of the clinical trials an d one of the. Twenty-three of the clinical studies were prospect ive, six. In three studies, intravenous phenytoin was given for the.
In the other 26 studies, the indicat ion for IV phenytoi n was. SE [ 8141539 — 42 ], acute repe titive seizures and rapid. For the dilantin and heart rate in epilepsy, the phenytoin dose was. The phenytoi n leve ls. The serum phenytoin level was found almost twofold of the. None of thos e patients developed a cardiovascular.
The auth ors commented that no cardiac monitoring was. Two large prospective studies with larg e numbers of. The olde r patients already had ischemic ECG. It was noted that all the. In the other prospective study, phenytoin was give n in a. The given dose chan. As the most fre quent adverse. In other studies containing small number of patients.
In the dilantin and heart rate studies where phenytoin was used. IV phenytoin was used for cardiac indications. Two of the patients died after they. Five deaths were reported in patients who received IV. In the third patienta dose of. The other two patients received high and rapidly infused.
The seru m phenytoin level was. The results of the study showed that IV phenytoin caused. All the patients in these. Table 1 The clinical trials with cardiovascular adverse effects of IV phenytoin infusion. Diagnosis for inclusion Dose of. Prospective 44—87 24 Digoxin intoxication and cardiac. Prospective 57 Digoxin intoxication and cardiac. Retrospective 16—85 17 SE Prospective dilantin and heart rate 38 SE, acute repetitive seizures. Prospective 20—87 46 SE, acute repetitive seizures, dilantin and heart rate.
Prospective 3—12 50 SE or new onset seizures 20 0 0 0. Prospective 14—73 15 SE 20 25—50 0 0 0. Dilantin and heart rate 0—8 10 SE 35 0 0 0.
Retrospective 12—82 Acute seizures Prospective 16—73 13 New onset of seizures, repetitive. Pediatric 27 Acute seizures 18 0 0 0. Prospective 14 Repetitive seizures 18 50 Prospective 13—83 46 Acute seizures 15 3. Prospective 4 Epilepsy 10 25 0 0 0. Prospective Adult 43 Epilepsy 16 40 1.