Presentation
We report a child presenting with ileus, hypothermia and lethargy after receiving supratherapeutic dosing of phenytoin after a concentration miscalculation. [ncbi.nlm.nih.gov]
Skin
- Dermatitis
) blood disorders ( D56 - D76 ) contact dermatitis ( L23 - L25 ) dermatitis due to substances taken internally ( L27.- ) nephropathy ( N14.0- N14.2 ) Includes adverse effect of correct substance properly administered poisoning by overdose of substance [icd10data.com]
Neurologic
- Cerebellar Ataxia
Conclusion 68% of patients on long–term phenytoin complained of poor balance and 52% had clinical evidence of ataxia. Cerebellar abnormalities on imaging were seen in 3/6 (50%) patients with ataxia. [jnnp.bmj.com]
This article has been cited by 1 Drug-Induced Cerebellar Ataxia: A Systematic Review J. van Gaalen,F. G. Kerstens,R. P. P. W. M. Maas,L. Härmark,B. P. [neurologyindia.com]
- Generalized Seizure
Seizures Symptoms and Types Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from... [medicinenet.com]
- Focal Seizure
Abstract Phenytoin is one of the most well established and most effective antiepileptic medications for the treatment of focal seizures. [ncbi.nlm.nih.gov]
Workup
Further workup for thrombo‐cytopenia was negative. Platelet count increased as the phenytoin level decreased, and her mental status followed the same pattern. [shmabstracts.com]
Urine toxicology, as well as acetaminophen, salicylic acid, and alcohol levels, should also be obtained to complete the toxicologic workup.[1][8] Treatment / Management There is no specific antidote for phenytoin toxicity, and the hallmark of treatment [ncbi.nlm.nih.gov]
Treatment
CASE REPORT: A 63-year-old man who was maintained with a stable dose of phenytoin for treatment of seizures began treatment with ticlopidine following percutaneous transluminal angioplasty and stent placement. [ncbi.nlm.nih.gov]
Prognosis
Prognosis Deaths are rare from phenytoin ingestion alone. Most reported cases involve ingestion of other substances along with phenytoin. Fatal cases of single phenytoin ingestions typically involve serum concentrations of greater than 125 mg/L. [ncbi.nlm.nih.gov]
Etiology
The etiology of phenytoin-induced gingival enlargement (PIGE) is likely due to the direct effects of the drug and its metabolites on the gingival fibroblasts. [ncbi.nlm.nih.gov]
Cardiovascular toxicity is extremely rare in oral overdose and should suggest other etiologies. Prolonged cardiac monitoring after oral ingestion is unnecessary. [emjournal.net]
Phenytoin 125mg TID had been added to this regimen one month prior to this presentation for the treatment of new onset seizures of undetermined etiology. There were no other recent medication changes reported by the group home staff. [ispub.com]
Epidemiology
Poisonings with Cardiotoxicants: Epidemiology, Features, Management, and Exceptional Therapies, 1st Edition. Springer UK. London UK 2013: 1-47. (Chapter). [emdocs.net]
Epidemiology According to the 2011 Annual Report of the American Association of Poison Control Centers (AAPCC) National Poison Data System, 1971 single-substance phenytoin exposures resulted in 46 major outcomes and 1 death.[4] Pathophysiology Like all [ncbi.nlm.nih.gov]
Pathophysiology
Phenytoin Toxicity Pathophysiology Stabilizes Na channels in the motor cortex increase seizure threshold Prolongs refractory period of vent. pacer, shortens action potential in heart Risk factors for toxicity Acute alcohol ingestion can increase levels [fprmed.com]
Epidemiology According to the 2011 Annual Report of the American Association of Poison Control Centers (AAPCC) National Poison Data System, 1971 single-substance phenytoin exposures resulted in 46 major outcomes and 1 death.[4] Pathophysiology Like all [ncbi.nlm.nih.gov]
PATHOPHYSIOLOGY The toxic effects of phenytoin depend on the route of administration, the duration of exposure, and the dosage used. Of these determinants of toxicity, the most important is the route of administration. [emjournal.net]
Prevention
Further, established polymorphisms should be documented to prevent toxicity of drugs metabolized by similar pathways. [ncbi.nlm.nih.gov]
Prevention Those who are taking phenytoin may prevent toxicity by taking the medication according to the prescription of the physician. [overdoseinfo.com]
Medication errors in nursing: Common types, causes, and prevention. Available at: https://www.medcomrn.com/index.php/articles/common-nursing-medication-errors-types-causes-prevention/Accessed on 2/6/2017. Antiepileptics, Sweetman SC, Martindale. [ijbcp.com]
Once she could breathe on her own and regained consciousness, she started taking phenytoin to prevent seizures. After her time in the intensive care unit, Susan was admitted to a rehabilitation program due to loss of muscle function. [personalizedprescribing.com]