Dilantin (amp)
PHENYTOIN
Pfizer Limited
Phenytoin is available as extended-release (long-acting) capsule, a chewable tablet, and a suspension (liquid) orally. The chewable tablet and suspension are usually taken two or three times a day. Phenytoin should be taken with food. When administering to patients on nasogastric or other enteral feeds, do not administer feeds 2 hr before or after a dose. Be consistent throughout therapy in relation to feed times. Do not switch dosage forms/brands with out prior consideration.
Store protected from moisture at temperature not exceeding 30°C.
Porphyria Avoid parenteral use in sinus bradycardia Sino-atrial block, second- and third-degree heart block Stokes-Adams syndrome Pregnancy
Anxiety Disorder : DEFINITION Anxiety can be described as an uncomfortable feeling of vague fear or apprehension accompanied by characteristic physical sensations. It is a normal and often beneficial response to situations that humans perceive as threatening, frightful, or otherwise disturbing. PATHOPHYSIOLOGY A neurocircuit arising from the output pathways of the central nucleus of the amygdala is thought to mediate fear and anxiety responses in humans.Dysregulated or exaggerated output through various amygdala-related circuits may be a common element underlying the different anxiety disorders, but the specific type of dysfunction probably differs among the various disorders. Several neurotransmitter systems have been linked to the neurobiology of anxiety: the inhibitory amino acid, ?-aminobutyric acid (GABA); the monoamine neurotransmitters, serotonin and norepinephrine; the excitatory amino acid, glutamate; and the neuropeptides, cholecystokinin (CCK), corticotrophin-releasing factor (CRF), neuropeptide Y (NPY), and substance P.2,3 Much of the evidence for these biologic processes has come from research on drugs that are used either to treat anxiety or to induce anxiety. Discovery of the anxiolytic effects of benzodiazepines in the early 1960s marked the beginning of this era of research. However, the anxiety-reducing properties of alcohol and barbiturates were recognized long before that time. Panic attack : Panic attacks are periods of intense fear or apprehension that are of sudden onset and of variable duration from minutes to hours.Panic attacks usually begin abruptly, may reach a peak within 10 to 20 minutes, but may continue for hours in some cases.Panic attacks usually subside on their own over the next several hours.Drug therapy include Benzodiazepines (alprazolam, clonazepam and lorazepam), Beta Blockers( carvedilol, propranolol, and timolol), Selective Serotonin Reuptake Inhibitors (fluoxetine, paroxetine and sertraline) and Selective and Norepinephrine Reuptake Inhibitors (Venlafaxine ).
Effects with other sedative drugs or ethanol may be potentiated. Enhances toxic effects of paracetamol, lithium. Increased risk of osteomalacia with acetazolamide. Decreased serum levels/effects with acyclovir, antineoplastics, benzodiazeines, ciprofloxacin, CYP2C9 inducers (e.g. carbamazepine), CYP2C19 inducers (e.g. rifampin), folic acid, vigabatrin. Increased serum concentrations with allopurinol, capecitabine, cimetidine, CYP2C9 inhibitors (e.g. fluconazole), CYP2C19 inhibitors (e.g. delavirdine), disulfiram, methylphenidate, metronidazole, omeprazole, SSRI, trazodone, trimethoprim. Increases metabolism of antiarrhythmics, anticonvulsants, antipsychotics, beta-blockers, calcium channel blockers, chloramphenicol, corticosteroids, doxycycline, oestrogens, HMG-CoA reductase inhibitors, methadone, theophylline, TCAs. Decreases levels/effects of clozapine, ciclosporin, tacrolimus, CYP2B6 substrates (e.g. bupropion, selegiline), CYP2C8 substrates (e.g. amiodarone).
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It is any effect of a drug, chemical, or other medicine that is in addition to its intended effect, especially an effect that is harmful or unpleasant.