Latest & greatest articles for phenytoin

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Top results for phenytoin

21. The use of Levetiracetam and Phenytoin for Seizure Prophylaxis in the Setting of Severe Traumatic Brain Injury

The use of Levetiracetam and Phenytoin for Seizure Prophylaxis in the Setting of Severe Traumatic Brain Injury "The use of Levetiracetam and Phenytoin for Seizure Prophylaxis in the " by Gregg V. Kosloff < > > > > > Title Author Date of Graduation Summer 8-11-2012 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Mark Pedemonte, MD Second Advisor Annjanette Sommers, PA-C, MS Rights . Abstract Background: Each year in the United States (...) an estimated 1.7 million people suffer a traumatic brain injury (TBI). Current standard of care for these patients is seven days of phenytoin (PHT) for seizure prophylaxis. Given the known side effect profile and drug interactions associated with the use of PHT, levetiracetam (LEV) has been proposed as an alternative for seizure prophylaxis. This systematic review examined available literature to determine whether or not there is sufficient evidence to recommend the use of LEV in lieu of PHT. Method

2012 Pacific University EBM Capstone Project

22. Should phenytoin and carbamazepine be avoided in Asian populations with the HLA-B*1502 positive genetic variant?

Should phenytoin and carbamazepine be avoided in Asian populations with the HLA-B*1502 positive genetic variant? BestBets: Should phenytoin and carbamazepine be avoided in Asian populations with the HLA-B*1502 positive genetic variant? Should phenytoin and carbamazepine be avoided in Asian populations with the HLA-B*1502 positive genetic variant? Report By: Subramanian Ganesan, Nahin Hussain - Specialist Registrars in Paediatrics Institution: Department of Paediatric Neurology, University (...) products Regulatory Agency (MHRA) and the UK Commission on Human Medicines) issued an alert on the antiepileptic drug (AED) phenytoin (PHT) regarding an increased risk of Steven–Johnson syndrome (SJS) associated with the presence of the HLA-B*1502 genetic variant in patients of Asian origin. Likewise, the US Federal Drug Agency (FDA) recommended genotyping for the allele in all Asian patients before starting carbamazepine (CBZ). We wanted to explore the implications of this for our clinical practice

2011 BestBETS

23. Folic acid supplementation prevents phenytoin-induced gingival overgrowth in children (Full text)

Folic acid supplementation prevents phenytoin-induced gingival overgrowth in children Gingival overgrowth is an important adverse effect of phenytoin (PHT) therapy, occurring in about half of the patients. This study aimed to evaluate the effect of oral folic acid supplementation (0.5 mg/day) for the prevention of PHT-induced gingival overgrowth (PIGO) in children with epilepsy aged 6-15 years on PHT monotherapy for 6 months.This was a randomized, double-blind, placebo-controlled trial

2011 EvidenceUpdates PubMed

24. Phenytoin: risk of Stevens-Johnson syndrome associated with HLA-B*1502 allele in patients of Thai or Han Chinese ethnic origin

Phenytoin: risk of Stevens-Johnson syndrome associated with HLA-B*1502 allele in patients of Thai or Han Chinese ethnic origin Phenytoin: risk of Stevens-Johnson syndrome associated with HLA-B*1502 allele in patients of Thai or Han Chinese ethnic origin - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Phenytoin: risk of Stevens-Johnson syndrome associated with HLA-B*1502 allele in patients of Thai or Han Chinese ethnic origin If patients are known to be HLA-B*1502-positive (...) , phenytoinshould be avoided when alternative therapy can be given. Published 11 December 2014 From: Therapeutic area: Contents Article date: January 2010 Phenytoin (brand leader Epanutin) is a commonly used antiepileptic drug. Phenytoin is one of the most common causes of antiepileptic-related cutaneous adverse reactions, including life-threatening Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). A recent study has shown a significant association between the human leukocyte antigen (HLA

2010 MHRA Drug Safety Update

25. Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumatic brain injury (Full text)

Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumatic brain injury Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumatic brain injury Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumatic brain (...) injury Kazerooni R, Bounthavong M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of intravenous levetiracetam, compared with conventional intravenous phenytoin, as prophylaxis against seizures

2010 NHS Economic Evaluation Database. PubMed

26. Oxcarbazepine versus phenytoin monotherapy for epilepsy. (Full text)

Oxcarbazepine versus phenytoin monotherapy for epilepsy. Worldwide, phenytoin is a commonly used antiepileptic drug. Oxcarbazepine is one of the newer antiepileptic drugs and has similar chemical properties to its parent compound carbamazepine. For the new drugs such as oxcarbazepine, it is important to know how they compare with standard treatments.To review the best evidence comparing oxcarbazepine and phenytoin when used as monotherapy in patients with epilepsy.We searched the Cochrane (...) a comparison of oxcarbazepine monotherapy with phenytoin monotherapy.This was an individual patient data review. Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Outcomes were (a) time on allocated treatment; (b) time to achieve 6, 12 and 24-month remission; (c) time to first seizure post randomization; (d) quality of life measures if available. Clinical heterogeneity was assessed by reviewing differences across trials

2006 Cochrane PubMed

27. Cost-effectiveness of oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin in the emergency department

Cost-effectiveness of oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin in the emergency department Cost-effectiveness of oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin in the emergency department Cost-effectiveness of oral phenytoin, intravenous phenytoin, and intravenous fosphenytoin in the emergency department Rudis M I, Touchette D R, Swadron S P, Chiu A P, Orlinsky M Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of oral phenytoin (poP), intravenous phenytoin (ivP), and intravenous fosphenytoin (ivF) for the treatment of patients presenting to the emergency department (ED) with seizures and sub-therapeutic phenytoin concentrations. poP was administered in increments

2004 NHS Economic Evaluation Database.

28. Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. (PubMed)

Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. Phenytoin and valproate are commonly used antiepileptic drugs. It is generally believed that phenytoin is more effective for partial onset (simple partial, complex partial and secondary generalized tonic-clonic seizures) seizures whilst valproate is more effective in generalized onset seizures (generalized tonic-clonic seizures, absence, myoclonus) although there is no evidence from (...) randomized controlled trials to support this belief. The use of individual patient data meta-analysis enabled us to examine time to event outcomes which are important in epilepsy monotherapy trials, and also to examine treatment-covariate interactions.To review the best evidence comparing phenytoin and valproate when used as monotherapy in subjects with partial onset seizures, or generalized onset tonic-clonic seizures with or without other generalized seizure types.Our search strategy included: (i

2001 Cochrane

29. Magnesium sulphate versus phenytoin for eclampsia. (PubMed)

Magnesium sulphate versus phenytoin for eclampsia. A number of different anticonvulsants are used to control eclamptic fits and to prevent further seizures.The objective of this review was to assess the effects of magnesium sulphate compared with phenytoin when used for the care of women with eclampsia. Magnesium sulphate is compared with diazepam and with lytic cocktail (in preparation) in other Cochrane reviews.We searched the Cochrane Pregnancy and Childbirth trials register and the Cochrane (...) Controlled Trials Register, Issue 3 1999.Randomised trials comparing magnesium sulphate (intravenous or intramuscular administration) with phenytoin for women with a clinical diagnosis of eclampsia.Trial quality was assessed and data extraction was done by two reviewers.Four trials involving 823 women were included. The trials were of good quality. Magnesium sulphate was associated with a substantial reduction in the recurrence of convulsions, when compared to phenytoin (relative risk 0.30, 95

2000 Cochrane

30. Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department (Full text)

Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Touchette D R, Rhoney D H Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) drug treatments. The effectiveness, in terms of stopping seizures, was assumed to be equal for both the drugs. Patients in status epilepticus, and those for whom intravenous phenytoin would not be administered, were excluded from the analysis. Outcomes assessed in the review The outcomes assessed in the review, and used as input parameters in the decision model, were mainly the clinical data on the rates of several adverse events. These were collected prospectively and retrospectively from

2000 NHS Economic Evaluation Database. PubMed

31. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. (PubMed)

Phenobarbital compared with phenytoin for the treatment of neonatal seizures. Seizures occur in 1 to 2 percent of neonates admitted to an intensive care unit. The treatment is usually with either phenobarbital or phenytoin, but the efficacy of the two drugs has not been compared directly.From 1990 to 1995, we studied 59 neonates with seizures that were confirmed by electroencephalography. The neonates were randomly assigned to receive either phenobarbital or phenytoin intravenously, at doses (...) sufficient to achieve free plasma concentrations of 25 microg per milliliter for phenobarbital and 3 microg per milliliter for phenytoin. Neonates whose seizures were not controlled by the assigned drug were then treated with both drugs. Seizure control was assessed by electroencephalographic criteria.Seizures were controlled in 13 of the 30 neonates assigned to receive phenobarbital (43 percent) and 13 of the 29 neonates assigned to receive phenytoin (45 percent; P=1.00). When combined treatment

1999 NEJM

32. An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy

An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy Heaney D C, Shorvon S D, Sander J W Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Four drugs used in monotherapy during the first two years of treatment for newly diagnosed patients with epilepsy were compared. These were Carbamazepine (CBZ), Phenytoin (PHT), Valproate (VPA) and Lamotrigine (LTG). Type

1998 NHS Economic Evaluation Database.

33. Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. (PubMed)

Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. The medical treatment of childhood epilepsy is largely influenced by clinical trials in adult patients. We know of only one randomised comparative trial (of two drugs) in newly diagnosed childhood epilepsy. We have undertaken a long-term, prospective, randomised, unmasked, pragmatic trial of the comparative efficacy and toxicity of four standard (...) antiepileptic drugs used as monotherapy in children with newly diagnosed epilepsy.Between 1981 and 1987, 167 children aged 3-16 years, who had had at least two previously untreated tonic-clonic or partial seizures, with or without secondary generalisation, were randomly allocated treatment with phenobarbitone, phenytoin, carbamazepine, or sodium valproate. The protocol was designed to conform to standard clinical practice. Efficacy was assessed by time to first seizure after the start of treatment and time

1996 Lancet

34. A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments

A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments Marchetti A, Magar R, Fischer J, Sloan E, Fischer P Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Intravenous (IV) fosphenytoin (Cerebyx) versus IV phenytoin (Dilantin) in patients needing an IV loading dose of phenytoin for the treatment or prevention of seizures in acute care settings. Type

1996 NHS Economic Evaluation Database.

35. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. (PubMed)

A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. Magnesium sulfate is used widely to prevent eclamptic seizures in pregnant women with hypertension, but few studies have compared the efficacy of magnesium sulfate with that of other drugs. Anticonvulsant prophylaxis with phenytoin for eclampsia has been recommended, but there are virtually no data to support its efficacy. Our objective was to compare magnesium sulfate with phenytoin in preventing seizures (...) in hypertensive women during labor.We randomly assigned women with hypertension who were admitted for delivery to receive either magnesium sulfate or phenytoin. The magnesium sulfate regimen consisted of a 10-g intramuscular loading dose followed by a maintenance dose of 5 g given intramuscularly every four hours. For women with severe preeclampsia, an additional 4-g loading dose was given intravenously. The phenytoin regimen included a 1000-mg loading dose infused over a period of 1 hour, followed by a 500

1995 NEJM

36. Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group. (PubMed)

Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group. Recessive dystrophic epidermolysis bullosa is an uncommon, severely disabling, heritable disorder characterized by abnormal fragility of the skin. Open trials have suggested that phenytoin is an effective treatment, and this therapy is now widely used.To determine the efficacy of phenytoin in the treatment of recessive dystrophic epidermolysis bullosa, we performed a randomized (...) , and seven patients withdrew before completing a single course. There was no significant difference in disease activity between phenytoin treatment and placebo treatment, as measured by changes in the number of blisters and erosions on the entire body (7 percent decrease vs. 6 percent increase), in the area of three designated plaques (0.4 percent decrease vs. 0.2 percent increase), or in the number of blisters and erosions in the designated plaques (12 percent decrease vs. 31 percent increase).Phenytoin

1992 NEJM

37. Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures. (PubMed)

Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures. In order to determine potential negative neurobehavioral effects of phenytoin given to prevent the development of posttraumatic seizures, 244 subjects were randomized to phenytoin or placebo. They received neurobehavioral assessments at 1 and 12 months postinjury while receiving their assigned drug and at 24 months while receiving no drugs. In the severely injured, phenytoin significantly impaired performance at 1 month (...) . No significant differences were found as a function of phenytoin in the moderately injured patients at 1 month or in either severity group at 1 year. Patients who stopped receiving phenytoin according to protocol between 1 and 2 years improved more than corresponding placebo cases on several measures. We conclude that phenytoin has negative cognitive effects. This, combined with lack of evidence for its effectiveness in preventing posttraumatic seizures beyond the first week, raises questions regarding its

1991 JAMA

38. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. (PubMed)

A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. Antiepileptic drugs are commonly used to prevent seizures that may follow head trauma. However, previous controlled studies of this practice have been inconclusive.To study further the effectiveness of phenytoin (Dilantin) in preventing post-traumatic seizures, we randomly assigned 404 eligible patients with serious head trauma to treatment with phenytoin (n = 208) or placebo (n = 196) for one year (...) in a double-blind fashion. An intravenous loading dose was given within 24 hours of injury. Serum levels of phenytoin were maintained in the high therapeutic range (3 to 6 mumol of free phenytoin per liter). Follow-up was continued for two years. The primary data analysis was performed according to the intention to treat.Between drug loading and day 7, 3.6 percent of the patients assigned to phenytoin had seizures, as compared with 14.2 percent of patients assigned to placebo (P less than 0.001; risk

1990 NEJM

39. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. (PubMed)

Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. We conducted a 10-center, double-blind trial to compare the efficacy and toxicity of four antiepileptic drugs in the treatment of partial and secondarily generalized tonic-clonic seizures in 622 adults. Patients were randomly assigned to treatment with carbamazepine, phenobarbital, phenytoin, or primidone and were followed for two years or until the drug failed (...) to control seizures or caused unacceptable side effects. Overall treatment success was highest with carbamazepine or phenytoin, intermediate with phenobarbital, and lowest with primidone (P less than 0.002). Differences in failure rates of the drugs were explained primarily by the fact that primidone caused more intolerable acute toxic effects, such as nausea, vomiting, dizziness, and sedation. Decreased libido and impotence were more common in patients given primidone. Phenytoin caused more dysmorphic

1985 NEJM

40. Placebo-controlled study of phenobarbitone and phenytoin in the prophylaxis of febrile convulsions. (PubMed)

Placebo-controlled study of phenobarbitone and phenytoin in the prophylaxis of febrile convulsions. Of 138 children who had a first febrile convulsion before their second birthday, 48 were treated with phenobarbitone, 47 with phenytoin, and 43 with a placebo for 12 months. Drug levels were monitored and adverse effects of the drugs were noted. Compared with placebo, phenobarbitone significantly reduced recurrences among children under 14 months old at the time of their first convulsion, but nor (...) among older children. Phenytoin was an ineffective prophylactic agent. Ideal drug levels were difficult to maintain, and many recurrences occurred when concentrations were suboptimal. Behavioural disturbance in children taking phenobarbitone was not a serious problem. The decision to give continuous prophylaxis for febrile convulsions is complex, and each case must be judged on its merits. For children who have a first seizure before 14 months of age prophylaxis may be advisable and phenobarbitone

1981 Lancet