Which medications in the drug class Anticonvulsants, Hydantoins are used in the treatment of Epilepsy and Seizures?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Anticonvulsants, Hydantoins

These agents stabilize sodium channels and prevent return of the channels to the active state.

Phenytoin (Dilantin, Phenytek)

Phenytoin is used to treat patients with partial, generalized, or mixed seizures, such as the tonic-clonic (grand mal) type. This agent works by blocking voltage-dependent neuronal sodium channels. The therapeutic concentration range of phenytoin in serum is 10-20 mcg/mL for patients who have normal renal function and serum albumin levels.

The risk of osteopenia and cerebellar ataxia, both of which are long-term adverse effects associated with phenytoin, now temper the drug's use by neurologists. This agent is one of the most difficult AEDs to use because of its zero-order kinetics and narrow therapeutic index. In addition, it can have significant bidirectional drug interactions.


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