Dilantin

Phenytoin.svg

Dilantin (generic name: phenytoin) is an anticonvulsant medication primarily used to manage and prevent certain types of seizures. It was first introduced in 1938 and remains a widely used treatment for epilepsy and other seizure disorders. Phenytoin acts by slowing down impulses in the brain that cause seizures.

Medical Uses

Dilantin is used to control tonic-clonic seizures and partial seizures with complex symptomatology. It can be administered orally or intravenously, making it versatile in acute care settings as well as for long-term outpatient management.

Mechanism of Action

Phenytoin works by modulating voltage-gated sodium channels in the brain, which helps to stabilize neuronal membranes and reduce repetitive neuronal firing. This action prevents the spread of seizure activity.

Pharmacokinetics

The absorption of phenytoin can be variable and is influenced by the formulation used. It is highly bound to plasma proteins and is metabolized in the liver by cytochrome P450 enzymes. The drug's elimination half-life varies, typically between 10 to 22 hours, but can be longer in cases of overdose or liver impairment.

Side Effects

Common side effects of Dilantin include gum hypertrophy, ataxia, nystagmus, and cognitive disturbances. Long-term use can lead to more severe effects such as osteoporosis, neuropathy, and various dermatological conditions. Monitoring levels of the drug in the blood can help manage these risks.

Interactions

Phenytoin interacts with a wide range of medications due to its effects on liver enzymes. It can decrease the effectiveness of certain drugs like oral contraceptives and increase the toxicity of others such as warfarin.

History

Developed in the 1930s, phenytoin was one of the first drugs that showed effectiveness in controlling seizures without causing significant sedation. It was discovered by scientists at Parke-Davis and Company and has since been a staple in the treatment of epilepsy.

Society and Culture

Generic versions of phenytoin are available, making it an affordable option for many patients. However, the brand name Dilantin is still widely recognized.

See Also

• Antiepileptic drugs
• Seizure types
• Neuropharmacology