Neurology Book

http://www.fpnotebook.com/

Dilantin Toxicity

Aka: Dilantin Toxicity, Phenytoin Toxicity
  1. See Also
    1. Phenytoin
    2. Fetal Hydantoin Syndrome
  2. Signs
    1. Phenytoin level 20 to 30 mcg/ml
      1. Nystagmus on lateral gaze
      2. Smooth Extraocular Movements lost
      3. Sedation
    2. Phenytoin level >30 mcg/ml
      1. Vertical Nystagmus
      2. Diplopia
      3. Ataxia or lurching gait
      4. Coarse extremity Tremor
      5. Slurred speech
      6. Altered Level of Consciousness
    3. Phenytoin Level >95 mcg/ml
      1. Lethal (deaths have occurred as low as 50 mcg/ml)
  3. Differential Diagnosis
    1. Posterior fossa tumor
    2. Acute viral cerebellitis
    3. Guillain-Barre Syndrome
    4. Botulism
    5. Anxiety Disorder
  4. Labs: Serial levels
    1. Serum free Phenytoin
    2. Serum Glucose
    3. Serum Creatinine
    4. Urinalysis
    5. Electrocardiogram
    6. Liver Function Tests
  5. Management
    1. Manage Hypotension
    2. Gastric Decontamination
    3. Treat complete Heart Block
      1. Atropine
      2. Pacemaker
    4. Treat Seizures
      1. Diazepam 0.1 to 0.3 mg/kg IV to 20 mg/dose
      2. May repeat Diazepam dosing in 20 minutes
  6. References
    1. Ellenhorn (1997) Medical Toxicology, p. 605-8
    2. Katzung (1989) Pharmacology, p. 289-91

PHENYTOIN TOXICITY (C0149969)

Concepts Injury or Poisoning (T037)
English PHENYTOIN TOXICITY
Sources
Derived from the NIH UMLS (Unified Medical Language System)


You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree