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Phenytoin- Pharmacology and popular brands

Phenobarbital, phenytoin, and valproate are widely used to treat Generalized Tonic-Clonic Seizures. However, each of these drugs is associated with dose-related and idiosyncratic adverse effects, and monitoring of hematological and hepatic function is routinely not advised.

ParametersDescription
Category of DrugPhenytoin is a Anticonvulsants/Antiepileptics
Mechanism of ActionPhenytoin promotes or decreases Na+ influx from membranes in motor cortex neurons; stabilizes neuronal membrane.
Chemical Structure Phenytoin.png
Molecular details Molecular Formula- C15H12N2O2
Molecular Weight- 252.27 g/mol
IUPAC Name5,5-diphenylimidazolidine-2,4-dione
IndicationsPhenytoin is used for
1. Generalized tonic-clonic seizures
2. Partial seizures
3. Status epilepticus.
Well Known
Pharmaceutical Brands
EPTOIN-ABBOTT
EPSOLIN- ZYDUS CADILA
DILANTIN- PFIZER
Available dosage forms1. TABLETS
2. CAPSULES
3. INJECTIONS
4. SUSPENSION 
Phenytoin Ikapharmindo Full Prescribing Information, Dosage & Side Effects  | MIMS Indonesia
TABLETS 2, 5 and 10 mg; CAPSULE 10 mg;
SUSPENSION 2 mg/ml; INJECTION 2 ml; ampoule (5 mg/ml).
DoseAdults- 18 mg/kg (do not exceed 50 mg/min as a loading dose);
maintenance dose -100 mg 6 to 8 hours.
Storage conditions Store protected from moisture at a temperature not exceeding 30⁰C
Pharmacokinetic properties 1. Phenytoin is completely absorbed.
2. Peak plasma concentration- 1.5-3 hours.
3. Vd-0.75 L/kg.
4. Protein binding- 90%
5. Phenytoin is extensively metabolized.
6. The majority is excreted as inactive metabolites
7. Half-life- 7 to 42 hours.
Contraindications1. Porphyria
2. Avoid parenteral use in sinus bradycardia
3. Sino-atrial block
4. Second- and
5. Third-degree heart block
6. Stokes-Adams syndrome
7. Pregnancy
Precautions1.  Hepatic impairment
2. lactation
3. Diabetes Mellitus
4. Monitor blood counts
5. Hypotension and heart failure
6. Intravenous administration-resuscitation facilities must be available
7. Injection solution alkaline
8. Interactions
Adverse Effects 1. Gastric intolerance
2. Headache
3. Sleeplessness
4. sedation
5. hallucinations
6. confusion
7. blurred vision
8. ataxia
9. nystagmus
10. diplopia
11. Slurred speech
12. cerebellar-vestibular symptoms,
Pregnancy Category D

References

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Drug

Zonisamide- Drug Detail Profile

Category of DrugZonisamide is a  Anticonvulsants/Antiepileptics drug
Mechanism of Action 
IndicationsZonisamide is used for 
1. Add-on in partial seizures
2. Primary generalized tonic-clonic seizures
3. Myoclonic epilepsy
4. Absence seizures
5. LGS
6. Infantile spasms.
Well Known
Pharmaceutical Brands
 
Available dosage forms1.  CAPSULES
2. TABLETS
Dose 
Contraindications 
Precautions Pregnancy
Adverse Effects1. Drowsiness
2.Anorexia
3.Ataxia
4.Fatigue
5. Photosensitivity
6.Cognitive effects- reversible psychic effects
7. Weight loss
8. Renal stones
Pregnancy Category C
Categories
Drug

Vigabatrin- Drug Detail Profile

Category of DrugVigabatrin is a  Anticonvulsants/Antiepileptics drug
Mechanism of Action 
Indications Vigabatrin is used for
1. Infantile spasms
2. Refractory partial seizures
with or without secondary generalization.
Well Known
Pharmaceutical Brands
 
Available dosage forms CAPSULES
Dose 
Contraindications 
Precautions Pregnancy
Adverse Effects 1. Psychosis
2. Behavioural problems
3. Hyperactivity
4. confusion
5. fatigue
6. insomnia,
7. ataxia
8. drowsiness
9. weight gain
10. facial
11. oedema
12. GIT upset
Pregnancy Category C
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Drug

Levetiracetam- Drug Detail Profile

Category of Drug Levetiracetam is a  Anticonvulsants/Antiepileptics
Mechanism of Action 
Indications  Levetiracetam is used for
1. Good effect difficult-to-treat idiopathic focal
epilepsies of childhood
2. Including variations such as continuous spike and wave during sleep or Landau-Kleffner syndrome
3. Photosensitivity and myoclonus- Generalised
epilepsy with photosensitivity
4. Idiopathic epilepsy– control of GTCS and Myoclonic
5. Treatment of postanoxic and post-encephalic
myoclonic epilepsy
6. epileptic encephalopathies-LGS
7. West Syndrome
8. Severe myoclonic epilepsy
9. Absence seizure
10. Rolandic epilepsy.
Well Known
Pharmaceutical Brands
 
Available dosage forms1. TABLETS
2. SYRUP
3. INJECTION
Dose 
Contraindications Hypersensitivity.
Precautions1. Renal disease
2. pregnancy
Adverse Effects 1. Most frequent somnolence
2. Asthenia
3. Headache
4. Hair loss
5. Vertigo
6. Infection
7. Behavioural changes such as hostility aggression 8. Apathy
Pregnancy Category C
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Drug

Gabapentin- Drug Detail Profile

Category of DrugGabapentin is a  Anticonvulsants/Antiepileptics
Mechanism of Action 
Indications Gabapentin is used for
1. Add-on drug in resistant partial seizures with or without secondary generalization
2. Rolandic epilepsy- preferred for safety reason, the first line in epilepsy patients with hepatic disease.
Well Known
Pharmaceutical Brands
 
Available dosage forms1. TABLETS
2. CAPSULES
Dose 
Contraindications Pregnancy
Precautions
Adverse Effects 1. Somnolence
2. Dizziness
3. Fatigue
4. Nystagmus
5. Behavioural changes (<10%)-aggression,
6. Hyperexcitability
7. Tantrum
8. Euphoria
9. Weight gain.
Pregnancy Category C
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Drug

Galantamine- Drug Detail Profile

Category of DrugGalantamine is an Anti-Alzheimer and Anti-Parkinsonism Drugs
Mechanism of Action 
Indications Galantamine is used to treat the symptoms of mild to moderate
1. Alzheimer’s disease
2. Dementia syndrome
Well Known
Pharmaceutical Brands
 
Available dosage forms1. TABLETS
2. CAPSULES
3. ORAL SOLUTION
Dose 
Contraindications 1. Hypersensitivity to galantamine
2. severe kidney and liver problems
3. Pregnancy
4. Lactating mothers
5. Children.
Precautions 1. Patients with asthma or lung disease
2. Epilepsy
3. Stomach ulcer
5. Take plenty of fluids during treatment.
Adverse Effects 1. Diarrhoea
2. Nausea
3. Anorexia and weight loss,
4. Chest pain or shortness of breath.
Pregnancy Category B

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Benzathine Benzyl Penicillin- Drug Detail Profile

Category of DrugBenzathine Benzyl Penicillin is an Anti-Infective drug
Mechanism of Action 
Indications Benzathine Benzyl Penicillin is used for
1. Mild to moderate infections of the upper
respiratory tract due to susceptible
streptococci
2. Syphilis
3. Prophylaxis of rheumatic fever.
Well Known
Pharmaceutical Brands
 
Available dosage forms INJECTABLE SUSPENSION
Dose 
Contraindications1. Hypersensitivity
2. Neurosyphilis.
Precautions 1. Hypersensitivity to cephalosporins or/
and penicillins
2. Elderly
3. Infants
4. Asthma
5. Kidney disease
6. lactation
7. interactions
Adverse Effects 1. Hypersensitivity reactions such as
exfoliative dermatitis
2. Pain at the injection site, thrombophlebitis of the injected vein
3. diarrhoea
4. Nausea
5. Joint pain
6. Angioedema
7. serum sickness
Pregnancy Category 
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Drug

Ceftazidime- Drug Detail Profile

Category of DrugCeftazidime is an Anti-Infective drug 
Mechanism of Action 
Indications1. Ceftazidime is used for
Infections are due to sensitive bacteria,
especially those due to Pseudomonas spp. and including those resistant to
aminoglycosides.
Well Known
Pharmaceutical Brands
 
Available dosage forms INJECTION
Dose 
Contraindications1. Cephalosporin hypersensitivity
2.porphyria.
Precautions1. Penicillin sensitivity
2. Renal impairment
3. lactation
4. False-positive urinary glucose
5. False-positive Coombs’ test
6. Pregnancy
Adverse Effects 1. Diarrhoea
2. Nausea
3. Vomiting
4. Abdominal
5. Discomfort
6. Headache
7. Antibiotic-associated colitis
8. Allergic reacons including rashes,
pruritus, urticaria
9. Serum sickness-like reaction
10. Toxic epidermal necrolysis reported
11. reversible interstitial nephritis
Pregnancy Category B
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Drug

Memantine- Drug Detail Profile

Category of DrugMemantine is an Anti-Alzheimer and Anti-Parkinsonism Drugs
Mechanism of Action 
Indications Memantine is used for
Treatment of moderate to severe dementia
of Alzheimer’s disease
Well Known
Pharmaceutical Brands
 
Available dosage forms 1. TABLETS
2. CAPSULES
3. ORAL SOLUTION
Dose 
Contraindications Hypersensitivity to memantine.
Precautions1. Seizure
2. The rise in urine pH results in increased plasma levels
3. Pregnancy
4. Lactation
5. Children.
Adverse Effects1.  Fatigue
2. Pain
3. Hypertension
4. Dizziness
5. Headache
6. Constipation
7. Vomiting
8. Backpain
9. Confusion
10. Somnolence
11. Hallucination
12. Coughing
13. Dyspnea
14. Insomnia
15. Urinary tract
16. Infections
Pregnancy Category B
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Drug

Cefixime- Drug Detail Profile

Category of Drug
Cefixime is an Anti-Infective drug
Mechanism of Action 
IndicationsCefixime is used for
1. Otitis media
2. Respiratory tract infections
3. Uncomplicated UTIs
4. effective against infections caused by
Enterobacteriaceae
5. H.influenza species
Well Known
Pharmaceutical Brands
 
Available dosage forms 1. TABLETS
2. CAPSULES
3. SYRUP/SUSPENSION
Dose 
Contraindications Hypersensitivity to cephalosporins.
Precautions1. History of allergy to penicillins
2. Renal failure
3. Patients under-going continuous ambulatory peritoneal
4. Gastrointestinal disease
5. Pregnancy
6. Interactions
7. Lactations
Adverse Effects1. Diarrhoea
2. Pseudomembranous colitis
3. Loose or frequent stools
4. Abdominal pain
5. Nausea dyspepsia
6. Hypersensitivity reactions
Pregnancy Category B