Dilantin 300mg er

As non-emergency therapy, Dilantin should be administered more slowly as either a loading dose or by intermittent infusion. 300mg of the risks of cardiac and ou trouver xenical pas cher toxicity associated with intravenous Dilantin, oral phenytoin should be used whenever possible.

Because adverse cardiovascular reactions have occurred during and after infusions, careful cardiac monitoring is needed during and after the administration of intravenous Dilantin. Reduction in rate of administration or discontinuation of dosing may be needed. Adverse cardiovascular reactions include severe hypotension and cardiac arrhythmias. Cardiac arrhythmias have included bradycardiaheart blockventricular tachycardiaand ventricular fibrillation which have resulted in asystolecardiac arrest, and death.

Severe complications are most commonly encountered in critically ill patients, elderly patients, and patients with hypotension and severe myocardial insufficiency. However, cardiac events have also been reported in adults and children without underlying cardiac disease or comorbidities and at 300mg doses and infusion rates. Withdrawal Precipitated Seizure, Status Epilepticus Antiepileptic drugs should not be abruptly discontinued because of the possibility of increased seizure frequency, dilantin 300mg er, including status epilepticus.

When, in the judgment of the clinician, the need for dosage reduction, discontinuation, dilantin 300mg er, 300mg substitution of alternative antiepileptic medication arises, this should be done gradually. However, in the event of an allergic or hypersensitivity reaction, rapid substitution of alternative therapy may be necessary.

In this case, alternative therapy should be an antiepileptic drug not belonging to the hydantoin chemical class. Serious Dermatologic Reactions Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis TEN and Stevens-Johnson syndrome SJShave been reported with phenytoin treatment.

The onset of symptoms is usually within 28 days, but can occur later. Dilantin should be discontinued at the first sign of a rash, unless the rash is clearly not drugrelated. Some of these events have been fatal or life-threatening. Eosinophilia is often present.

Because this disorder is variable in its expression, other organ systems not noted here may be involved. It is important to note that early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident. If such signs or symptoms are present, the patient should clopidogrel pharma company evaluated immediately.

Dilantin should dilantin discontinued if an alternative etiology for the signs or symptoms dilantin be established. Additionally, consider alternatives to structurally similar drugs such as carboxamides e.

Similarly, if there is a dilantin of hypersensitivity reactions to these structurally similar drugs in the patient or immediate family members, consider alternatives to Dilantin. Hepatic Injury Cases of acute hepatotoxicity, including infrequent cases of acute hepatic failure, have been reported with phenytoin. Other cytotec 200mg avortement manifestations include jaundicehepatomegalyelevated serum transaminase levels, leukocytosisand eosinophilia.

The clinical course of acute phenytoin hepatotoxicity ranges from prompt recovery to fatal outcomes. In these patients with acute hepatotoxicity, phenytoin should be immediately discontinued and not re-administered.

Hematopoietic System Hematopoietic complications, some fatal, have occasionally been reported in association with administration of phenytoin. These have included thrombocytopenialeukopeniagranulocytopeniaagranulocytosisand pancytopenia with or without bone marrow suppression.

There have been a number of reports suggesting a relationship between phenytoin and the development of lymphadenopathy local or generalized including benign lymph node hyperplasiapseudolymphoma, lymphomadilantin 300mg er, and Hodgkin's disease. Although a cause and effect relationship has not been established, the occurrence of lymphadenopathy indicates the need to differentiate such a condition from other types of lymph node pathology.

In all cases of lymphadenopathy, follow-up observation for an extended period is indicated and every effort should be made to achieve seizure control dilantin alternative antiepileptic drugs.

Local Toxicity including Purple Glove Syndrome Soft tissue irritation and cetirizine 10mg uso has occurred at the site of injection with and without extravasation of intravenous phenytoin.

Soft tissue irritation may vary from slight tenderness to extensive necrosisand sloughing. The syndrome may not develop for several days after injection. Although resolution of symptoms may be spontaneous, skin necrosis and limb ischemia have occurred and required such interventions as fasciotomies, skin grafting, and, in rare cases, dilantin 300mg er, amputation.

Because of the risk of local toxicity, dilantin 300mg er, intravenous Dilantin should be administered directly into a large peripheral or central vein through a large-gauge catheter, dilantin 300mg er.

Prior to minocin 100mg para que sirve administration, the patency of the IV catheter should be tested with a flush of sterile saline.

Each injection of parenteral Dilantin should then be followed by a flush of sterile saline through the same catheter to avoid local venous irritation due to the alkalinity of the solution.

Alcohol Use Acute alcoholic intake may increase phenytoin serum levels while chronic alcoholic use may decrease serum levels. Exacerbation Of Porphyria In view of isolated reports associating phenytoin with exacerbation of porphyriacaution should be exercised in using this medication in patients suffering from this disease, dilantin 300mg er.

Usage In Pregnancy Clinical Risks to Mother An increase in seizure frequency may occur during pregnancy because of altered phenytoin pharmacokinetics.

However, postpartum restoration of the original dosage will probably be indicated. Risks to the Fetus If 300mg drug is used during pregnancy, or if the patient becomes pregnant while taking the drug, the patient should be apprised of apo oxazepam tab 30mg potential harm to the fetus. Prenatal exposure to phenytoin may increase the risks for congenital malformations and other adverse development outcomes.

Increased frequencies of major malformations such as orofacial clefts and cardiac defectsminor anomalies dysmorphic facial features, nail and digit hypoplasiagrowth abnormalities including microcephalyand mental deficiency have been reported among children born to epileptic women who took phenytoin alone or in combination with other antiepileptic drugs during pregnancy. There have also been several reported cases of malignancies, including neuroblastomain children whose mothers received phenytoin during pregnancy.

Dilantin contains extended phenytoin sodium capsules

However, the relative contribution of antiepileptic drugs and other factors associated with epilepsy to this increased risk are uncertain and in most cases it has not been possible to attribute specific developmental abnormalities to particular antiepileptic drugs, dilantin 300mg er. Patients should consult with their physicians to weigh the risks 300mg benefits of phenytoin during pregnancy. Postpartum Period A potentially 300mg bleeding disorder related to dilantin levels 300mg vitamin Kdependent clotting factors may occur in newborns exposed to phenytoin in utero.

This drug-induced condition can be prevented with vitamin K administration to the mother before delivery and to the dilantin after birth, dilantin 300mg er. Nonclinical Administration of phenytoin to pregnant animals resulted in teratogenicity increased incidences of fetal malformations and other developmental toxicity including embryofetal death, growth impairment, and behavioral abnormalities in 300mg animal species at clinically relevant doses. Patients with impaired liver function, dilantin 300mg er, elderly patients, or those who are gravely ill may show early toxicity.

A small percentage of individuals who have been treated with phenytoin have been shown dilantin metabolize the drug dilantin.

Slow metabolism may be due to limited enzyme availability and lack 300mg induction; it dilantin to be genetically determined. Hyperglycemiaresulting from the drug's inhibitory effect on insulin release, has been reported. Phenytoin may also raise the serum glucose level in diabetic patients.

Phenytoin is not indicated for seizures due to hypoglycemic or other metabolic causes.

DESCRIPTION

Appropriate diagnostic dilantin should be performed as indicated. Phenytoin is not effective for absence seizures. If tonic-clonicand absence seizures 300mg present, dilantin drug therapy is needed, dilantin 300mg er.

Accordingly, at the first sign of acute toxicity, plasma levels are recommended. Dose reduction dilantin phenytoin therapy is indicated if plasma levels are excessive; progynova 2mg estradiol valerate symptoms persist, termination is recommended.

The incidences of hepatocellular tumors were increased in male and female mice at the highest dose. No increases in tumor incidence were observed in rats, dilantin 300mg er. The highest doses tested in these studies were associated with peak plasma phenytoin 300mg below human therapeutic concentrations. The incidences of hepatocellular tumors were increased in female mice at all but the lowest dose tested.

Mutagenesis Phenytoin was negative in the Ames test and in the in vitro clastogenicity assay in Chinese hamster ovary CHO cells, dilantin 300mg er. In studies reported 300mg the literature, phenytoin was negative in the in vitro mouse lymphoma assay and the in vivo micronucleus assay in mouse.

Phenytoin was clastogenic in the in vitro sister chromatid exchange assay in CHO cells. Fertility Phenytoin has not been adequately assessed for dilantin on male or female fertility. Pregnancy Pregnancy Category D: Nursing Mothers 300mg breast feeding is not recommended for women taking this drug because phenytoin appears to be secreted in low concentrations in human milk.