ATI – Pharmacology (PRACTICE A)

phenytoin
ADVERSE EFFECTS (7)
CNS effects (nystagmus, sedation, ataxia, double vision, cognitive impairment)
Gingival hyperplasia (softening and overgrowth of gum tissue, tenderness, and bleeding gums)
-Maintain good oral hygiene
Skin rash
Teratogenic (cleft palate, heart defects)
Cardiovascular effects (dysrhythmias, hypotension)
-Administer at slow IV rate in dilute solution
-IV route for status epilepticus
-Avoid administering to client who has sinus bradycardia, sinoatrial block, or Strokes-Adams syndrome
Endocrine and other effects (coarsening of facial features, hirsutism, and interference with vitamin D metabolism)
-Consume adequate amounts of calcium and vitamin D
Interfere with vitamin K-dependent clotting factors causing bleeding in newborns
-Administer prophylactic vitamin K to mother for 1 month before infant delivered

phenytoin
INTERACTIONS
PHENYTOIN CAUSES A DECREASE IN EFFECTS OF… (3)
-Oral contraceptives
-Warfarin (Coumadin)
-Glucocorticoids
Because of the stimulation of hepatic drug-metabolizing enzymes

phenytoin
INTERACTIONS
INCREASE PHENYTOIN LEVELS (4)
-Alcohol
-Diazepam (Valium)
-Cimetidine (Tagamet)
-Valproic acid

phenytoin
INTERACTIONS
DECREASE PHENYTOIN LEVELS (3)
-Carbamazepine (Tegretol)
-Phenobarbital
-Chronic alcohol use

phenytoin
INTERACTIONS
ADDITIVE CNS DEPRESSANT EFFECTS (2)
CNS depressants:
-Barbiturates
-Alcohol

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