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So next let me discuss about the phenytoin so phenytoin it is an oral anti-epileptics rum right it is an oral anti-epileptics drug and we have a product of this particular phenytoin which is called phosphonate oil right which is called phosphonate oil remember phosphonate oil it is a water-soluble right it is a water soluble product right remember this one
Phosphate oil is a water soluble product of the night oil and you makes any time the route of administration is oral whereas you take phosphonate oil the route of administration of this drug is intravenous or intramuscular route of administration and where is this used this phosphonate oil remember whenever we give either intravenously or intramuscularly this is
Useful for the treatment of acute attack of seizures in case of status epilepticus right is used in acute attacks of seizures in status epilepticus all right in status epilepticus now what is the mechanism of action of these particular drugs remember these drugs they act by blocking right these act by blocking the sodium channels right they act by blocking the
Sodium channels now where do we use this particular phenotype this phenytoin we use this in case of gtcys generalized tonic-clonic seizures and as well ask this is also used in case of the partial seizures right also used in the treatment of the partial seizures all right the other users of this particular phenytoin is it can also be used as the anti-arrhythmic
Drug right it can also be used as the anti-arrhythmic drug and like we have various classes of the anti enemy growth class 1 2 3 4 and as well as 5 and class 1 antiarrhythmic drugs are again sub classified into class 1a 1b and as well as one see if you take this point which is having the antiarrhythmic property it is class 1 be anti admit property right it is
Having class 1b anti endemic property that means by blocking the sodium channels and this would be an anti-arrhythmic property of the phenytoin it is used in case of digital is induced athenians so in case of digital isn’t used athenians we give this particular phenytoin and this is class 1b anti-immigrant now recently it has been found to enhance or increase
The old healing right the other uses it will enhance the old healing this is another use of this particular phenytoin alright next now this phenytoin it follows saturation kinetics right it follows what is called as saturation kinetics alright now what is this saturation kinetics is the pharmacokinetic property of the finit oil initially it will be the first
Order kinetics it will follow what is called the first order kinetics now what do you mean by the saturation can it exists this particular kinetics they change kinetics changes from first order to the zero order kinetics alright the kinetics it changes from the first order to the zero order kinetics right within the therapeutic concentration now and now let me
Discuss what will happen if the individual is having the phenotype toxicity right what will happen if the individual is having senatorial toxicity now remember at toxic doses right a toxic doses the finna toil it can result in cerebellar symptoms but it can result in cerebellar symptoms now what do you think will be the cerebellar symptoms cerebellar symptoms
They include ataxia ataxia is what imbalance in the gait ataxia is one of the cerebellar symptom and the other one is what i go next is nystagmus right so these are some of the cerebellar symptoms right so at toxic levels remember the phenytoin will cause the cerebellar symptoms like ataxia what tygo nystagmus and as well as diplopia now now remember whenever
You are giving phosphonate oil phosphate entering i have said you it can be given intravenously a four intramuscularly so whenever you are giving first phenytoin you have to give by slow iv infusion right you have to give it by slow iv infusion why because when you give this finit oil very fastly remember the fast administration of the finit tine at very high
Doses that can lead to anemia cardiovascular collapse and coma remember this point so phenytoin it should always be given in the form of slow iv infusion because the faster administration of high doses can lead to anemia cardiovascular collapse and as well as coma alright next when we use this phenytoin chronically remember the chronic use of phenytoin can result
In what is called asked gingival hyperplasia or gum hypertrophy right will result in gingival hyperplasia or gum hypertrophy now why is this gum hypertrophy or guinea well hyperplasia due to remember this gimel hyperplanes your gamma hypertrophy it results due to over expression of the platelet derived growth factors right so this is due to or expression of
Platelet-derived growth factor so due to or expression of this particular platelet-derived growth factor the individual will develop giggle hyperplasia or gum hypertrophy now this particular gamma hypertrophy or giggle hyperplasia will regress after the discontinuation of sanatorium right so this gum hypertrophy will regress after discontinuation of phenytoin
Right after the discontinuation of the phenytoin the gum hypertrophy or being a well hyperplasia will be regressed now apart from this particular gamma hypertrophy remember the other adverse effects of the phenytoin the other adverse effects of the finna time it will post hirsutism that is excessive growth of the body hair so hirsutism is another address effect
With the phenytoin for signing off facial features right questioning of the facial features is another important diverse effects with the phenytoin and these individuals they develop megaloblastic anemia right these individuals they develop megaloblastic anemia and the final training news megaloblastic anemia this should be treated with folic acid right finito
An induced megaloblastic anemia should be treated with the folic acid all right and the other adverse effects with the phenytoin is this finit oil it will also cause vitamin d deficiency because this finna time will cause vitamin d deficiency the individual will line up in either rickets or osteomalacia or osteomalacia and the other adverse effects is it will also
Cause vitamin k deficiency and that will results in the coagulation of normalities within the individual and this drug will also cause hyperglycemia that is increase in the blood glucose levels now how it will cause hyperglycemia is remember phenytoin we leave it the insulin release so hyperglycemia is due to night it is due to decrease in the insulin release
Right so due to decrease in the insulin release this phenytoin vapors this hyperglycemia now the other important point is you take this particular phenytoin sinha towing it way it has what is called as teratogenicity so when finit owen is taken in a pregnant mother this will have the tie rack to genic effect now what is the teratogenic effect of this particular
Phenytoin is the finite owen will cause what is called as the fetal hydrant oil syndrome fetal hydrant wine syndrome that is the teratogenic effect of the senate oil in the fetus now what does this fetal hydrant oil syndrome it includes is this fetal hydrant oil syndrome it includes the hypoplastic challenges that is the fingers there will be hypoplastic the
Fetal hydrant wine syndrome it includes the cleft lip the cleft palate and as well as microcephaly and as well as microcephaly so these are the components of the fetal hydrant oil syndrome so let me shortly summarize or revise about the entire phenytoin so phenytoin is an antiepileptic drug which is given in the form of oral administration we have a prodrug of
The phenytoin which is first phenytoin which is a water-soluble product and the route of administration of this phosphonate oil is either intravenous or intramuscular route and where do we use this phosphonate oil but why are intravenous route is in case of acute attacks of seizures in case of status epilepticus we use this phosphate oil via intravenous route
And whenever you are giving phosphonate oil in via intravenous route that has to be given via by slow iv infusion because the faster administration of a very high dose will result in edenia and as well as the cardiovascular collapse in the mechanism of action of this phenytoin is by blocking the sodium channels the sodium entry into the neuronal cells will not
Occur and thereby the exaggeration of the neuronal cells will not occur and thereby the epilepsy will be reduced and where all will be used this phenytoin this phenytoin it is used in g tcs generalized tonic-clonic epilepsy partial seizures and not only that this phenytoin it is also having the antiarrhythmic property it is used as the class 1b and clear demi
Drug and recently this phenytoin has been found to enhance the own healing and not only that in digitalis induced edenia phenytoin can be given now you take this minute oil it follows the saturation kinetics in the sense initially it is metabolized by first-order kinetics followed by that the zero order kinetics and whenever you give this ferret or any toxic
Doses it will cause cerebellar symptoms like ataxia what i go nystagmus and as well as diplopia and whenever you use this phenytoin chronically the chronic use of phenytoin will result in what is called as gamma hypertrophy and this particular gum hypertrophy is due to or expression of the platelet derived growth factor and this gum hypertrophy it will regress
After the discontinuation of the finish line and this finna time will also cause vitamin d deficiency and vitamin k deficiency so vitamin d deficiency will result in rickets or osteomalacia and vitamin k deficiency will result in the choir relation abnormalities and this phenytoin will also cause hyperglycemia due to decrease in the insulin release and the other
Adverse effects with the finit orion is it will cause excessive growth of the body here which is called as judaism and it will also cause arsenic of the facial features and it will also cause megaloblastic anemia the megaloblastic anemia which is caused by the phenytoin should be treated with the folic acid then this finit oil it also has the teratogenic effect
In a pregnant mother if phenytoin is given the fetus will develop what is called as fetal hydrant oil syndrome which includes the hypoplastic challenges cleft lip cleft palate and as well as microcephaly so this is completely about your phenytoin so as we have many adverse effects with the finit orion and it is difficult to remember these many adverse effects so
I’ll give you all these adverse effects of phenytoin in the form of a mnemonic right so the adverse effects of phenytoin right the adverse effects of the phenytoin so the mnemonic is h.o.t hot ma like20 light so what does this hedge transfer remember the word h stands for his suit ism or hypertrophy of the gums that is due to and hypertrophy of the gums is due
To exaggerated expression of the pdgf platelet-derived growth factor and o stands for osteomalacia that is due to vitamin d deficiency t stands for teratogenicity that is fatal hydrant oil syndrome which includes the hypoplastic felling juice microcephaly cleft palate and then cleft lip and then we have megaloblastic anemia that can occur because of the finite
Time usage for long term and this should be treated with the folic acid and toxic doses of the phenytoin will result in the cellular symptoms like ataxia and as well as nystagmus what tygo and diplopia and l stands for lymph adenopathy phenytoin will also cause lymph adenopathy next the word i transferred the finit ein will inhibit the insulin release and thereby
The individual will land up in what is called as hyperglycemia the k stands for phenytoin will cause the vitamin k deficiency and the word a science for rd mia’s so this particular phosphate wine if it is used or if it is administered fastly in higher doses that will result in earthiness and as well as cardiovascular collapse so these are the adverse effects of phenytoin
Transcribed from video
PHENYTOIN Pharmacology : Antiepileptic Drugs By Dr.G Bhanu Prakash Animated Medical VideosliveBroadcastDetails{isLiveNowfalsestartTimestamp2019-12-31T095815+0000endTimestamp2019-12-31T101709+0000}
