Phenytoin in afya

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used in management of seizures.

''Mechanism of action''
    sodium channel blocker, decreasing the sodium influx into neurons which in turn decreases excitability

''Adverse effects''
''Acute''
    initially: dizziness, diplopia, nystagmus, slurred speech, ataxia
    later: confusion, seizures
''Chronic''
    common: gingival hyperplasia (secondary to increased expression of platelet derived growth factor, PDGF), hirsutism, coarsening of facial features, drowsiness
    megaloblastic anaemia (secondary to altered folate metabolism)
    peripheral neuropathy
    enhanced vitamin D metabolism causing osteomalacia
    lymphadenopathy
    dyskinesia
''Idiosyncratic''
    fever
    rashes, including severe reactions such as toxic epidermal necrolysis
    hepatitis
    Dupuytren's contracture
    aplastic anaemia
    drug-induced lupus
''Teratogenic''
    associated with cleft palate and congenital heart disease

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