December 1, Dr. Combs is acting instructor and Dr. Romm is associate clinical professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington in Seattle. The authors report no affiliation with or financial interest in any organization that may pose a conflict of interest.
Mouth[ edit ] Phenytoin has been associated with drug-induced gingival enlargement overgrowth of the gumsprobably due to above-mentioned folate deficiency; indeed, evidence from a randomized controlled trial suggests that folic acid supplementation can prevent gingival enlargement in children who take phenytoin.
Effects consist of the following: HypertrichosisStevens-Johnson syndromepurple glove syndromerash, exfoliative dermatitis, itchingexcessive hairinessand coarsening of facial features can be seen in those taking phenytoin. Phenytoin is primarily metabolized to its inactive form by the enzyme CYP2C9.
Variations within the CYP2C9 gene that result in decreased enzymatic activity have been associated with increased phenytoin concentrations, as well as reports of drug toxicities due to these increased concentrations. Phenytoin induces metabolizing enzymes in the liver.
This leads to increased metabolism of vitamin Dthus decreased vitamin D levels. Vitamin D deficiencyas well as low calcium and phosphate in the Disposition effect literature review cause decreased bone mineral density.
Antacids administered in a peptic ulcer regimen may decrease the AUC of a single dose of phenytoin.
Patients should be cautioned against concomitant use of antacids and phenytoin. Consider using other options if possible.
This is accomplished by reducing the amplitude of sodium-dependent action potentials through enhancing steady state inactivation. Sodium channels exist in three main conformations: Phenytoin binds preferentially to the inactive form of the sodium channel.
Because it takes time for the bound drug to dissociate from the inactive channel, there is a time dependent block of the channel. Since the fraction of inactive channels is increased by membrane depolarization as well as by repetitive firing, the binding to the inactive state by phenytoin sodium can produce voltage-dependent, use-dependent and time-dependent block of sodium-dependent action potentials.
This includes the reduction of post-tetanic potentiation at synapses which prevents cortical seizure foci from detonating adjacent cortical areas.
Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of generalized tonic-clonic seizures. A small increase in dose may lead to a large increase in drug concentration as elimination becomes saturated.
The time to reach steady state is often longer than 2 weeks. Inoutside scientists including H. Jack Dreyfusfounder of the Dreyfus Fundbecame a major proponent of phenytoin as a means to control nervousness and depression when he received a prescription for Dilantin in He is believed[ by whom?
This was partially because Parke-Davis was reluctant to invest in a drug nearing the end of its patent life, and partially due to mixed results from various studies. The list identifies medications that the FDA has identified a potential safety issue, but does not mean that FDA has identified a causal relationship between the drug and the listed risk.
To address this concern, the Warnings and Precautions section of the labeling for Dilantin injection was updated to include additional information about purple glove syndrome in November Literature review was performed for articles published between and in electronic databases.
Sixteen articles met the inclusion criteria. Data were analyzed by R version for windows. Emotional Eating 1 Sample Literature Review This is a literature review I wrote for Psychology / Research Methods I.
It received an A. The assignment was to read a . Masters Thesis Proposal Outline INTRODUCTION (1 PAGE) • What is the general topic area broader community, etc.) • What is the specific scope of your research interest LITERATURE REVIEW (PP) • The literature review should be a well-organized overview of .
A literature review is not an annotated bibliography in which you summarize briefly each article that you have reviewed.
While a summary of the what you have read is contained within the literature review, it goes well beyond merely summarizing professional literature.
Effect of Hypothermia and Targeted Temperature Management on Drug Disposition and Response Following Cardiac Arrest: A Comprehensive Review of Preclinical and Clinical Investigations (PKs) and pharmacodynamics (PDs). We aim to evaluate the current literature on the effect of TTM on drug PKs and PDs following CA.
MEDLINE/PubMed databases. alphabetnyc.com: An Archaeology of Sympathy: The Sentimental Mode in Literature and Cinema (): James Chandler: Books.