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Phenytoin may accumulate in the cerebral cortex over long periods of time which can cause atrophy of the cerebellum. The degree of atrophy is related to the duration of phenytoin treatment and is not related to dosage of the medication. [23] Phenytoin is known to be a causal factor in the development of peripheral neuropathy. [24]
Phenytoin/pentobarbital (trade name Beuthanasia-D Special) is an animal drug product used for euthanasia, which contains a mixture of phenytoin and pentobarbital. [1] It is administered as an intravenous injection to give animals a quick and humane death.
Continuing the maintenance dose for about 4 to 5 half-lives (t 1/2) of the drug will approximate the steady state level. [1] One or more doses higher than the maintenance dose can be given together at the beginning of therapy with a loading dose. [2] A loading dose is most useful for drugs that are eliminated from the body relatively slowly ...
A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life. Such drugs need only a low maintenance dose in order to keep the amount of the drug in the body at the appropriate therapeutic level, but this also means that, without an initial higher dose, it would take a long ...
It is taken alone, or in combination with complementary agents such as phenytoin, in commercial animal euthanasia injectable solutions. [5] [6] Pentobarbital sodium (CAS No. 57-33-0) In the Netherlands, pentobarbital is part of the standard protocol for physician-assisted suicide for self-administration by the patient. [11]
Fosphenytoin is approved in the United States for the short-term (five days or fewer) treatment of epilepsy when more widely used means of phenytoin administration are not possible or are ill-advised, [4] such as endotracheal intubation, status epilepticus or some other type of repeated seizures; cluster seizure, vomiting, and/or the patient is unalert or not awake or both.
There may be an increase in the clearance and resultant decrease in the blood concentration of lamotrigine, phenytoin, and to a lesser extent carbamazepine, and possibly decreases the level of levetiracetam and the active oxcarbazepine metabolite, the monohydroxy derivative. [94]
The formula for determining the dose is: [1] If there is a single recommended maintenance dose in the literature, this is preferred. If there are a range of recommended maintenance doses then If the literature recommends generally increasing from initial to maximum dose provided it is tolerated, pick the maximum dose.