Cardiovascular adverse effects of phenytoin

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dc.authoridRemi, Jan/0000-0003-1527-9350
dc.authoridGULDIKEN, Baburhan/0000-0002-9006-1880
dc.authorwosidRémi, Jan/AAF-1170-2020
dc.contributor.authorGuldiken, B.
dc.contributor.authorRemi, J.
dc.contributor.authorNoachtar, Soheyl
dc.date.accessioned2024-06-12T11:00:31Z
dc.date.available2024-06-12T11:00:31Z
dc.date.issued2016
dc.departmentTrakya Üniversitesien_US
dc.description.abstractPhenytoin is an established drug in the treatment of acute repetitive seizures and status epilepticus. One of its main advantages over benzodiazepines is the less sedative effect. However, the possibility of cardiovascular adverse effects with the intravenous use of phenytoin cause a reluctance to its usage, and this has lead to a search for safer anticonvulsant drugs. In this study, we aimed to review the studies which evaluated the safety of phenytoin with respect to cardiovascular adverse effects. The original clinical trials and case reports listed in PUBMED in English language between the years of 1946-2014 were evaluated. As the key words, phenytoin, diphenylhydantoin, epilepsy, seizure, cardiac toxicity, asystole, arrhythmia, respiratory arrest, hypotension, death were used. Thirty-two clinical trials and ten case reports were identified. In the case reports, a rapid infusion rate (> 50 mg/min) of phenytoin appeared as the major cause of increased mortality. In contrast, no serious cardiovascular adverse effects leading to death were met in the clinical trials which applied the recommended infusion rate and dosages. An infusion rate of 50 mg/min was reported to be safe for young patients. For old patients and patients with a cardiovascular co-morbidity, a slower infusion rate was recommended with a careful follow-up of heart rhythm and blood pressure. No cardiovascular adverse effect was reported in oral phenytoin overdoses except one case with a very high serum phenytoin level and hypoalbuminemia. Phenytoin is an effective and well tolerated drug in the treatment of epilepsy. Intravenous phenytoin is safe when given at recommended infusion rates and doses.en_US
dc.identifier.doi10.1007/s00415-015-7967-1
dc.identifier.endpage870en_US
dc.identifier.issn0340-5354
dc.identifier.issn1432-1459
dc.identifier.issue5en_US
dc.identifier.pmid26645393en_US
dc.identifier.scopus2-s2.0-84949493928en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage861en_US
dc.identifier.urihttps://doi.org/10.1007/s00415-015-7967-1
dc.identifier.urihttps://hdl.handle.net/20.500.14551/20868
dc.identifier.volume263en_US
dc.identifier.wosWOS:000376141000003en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer Heidelbergen_US
dc.relation.ispartofJournal Of Neurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectEpilepsyen_US
dc.subjectPhenytoinen_US
dc.subjectCardiovascular Adverse Effectsen_US
dc.subjectArrhythmiaen_US
dc.subjectDeathen_US
dc.subjectIntravenous-Sodium Diphenylhydantoinen_US
dc.subjectAcute Repetitive Seizuresen_US
dc.subjectStatus Epilepticusen_US
dc.subjectCardiac Arrhythmiasen_US
dc.subjectOral Phenytoinen_US
dc.subjectEmergency-Departmenten_US
dc.subjectInfusionen_US
dc.subjectFosphenytoinen_US
dc.subjectValproateen_US
dc.subjectChildrenen_US
dc.titleCardiovascular adverse effects of phenytoinen_US
dc.typeReview Articleen_US

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