Monday, 30 November 2015
Dilantin (phenytoin)
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Dilantin
Information
Dilantin is approved for use
as an anti-seizure medication (anticonvulsant), especially to prevent
tonic-clonic (grand mal) seizures and complex
partial seizures (psychomotor seizures). It may be used alone or
with Phenobarbital or other anticonvulsants.
Dilantin can increase the
metabolism (elimination) of many drugs, reducing their concentrations in the
body. Drugs that may be affected include: digoxin, carbamazepine,
clonazepam, corticosteroids (e.g.prednisone), cyclosporine,
disopyramide, doxycycline, estrogens, felodipine, levodopa,
lidocaine, methadone, mexiletine, oral contraceptives, paroxetine,
quinidine, tacrolimus, theophylline, phenobarbital, and warfarin.
Dilantin can interact with these drugs not only when it is added to therapy
but also when it is discontinued. In the latter case, the concentration of
the other drugs may increase. Dilantin's metabolism may be affected by other
drugs. Drugs that can reduce the amount of Dilantin in the body
include rifampin and phenobarbital. Drugs that increase Dilantin
concentrations include Amiodarone, chloramphenicol,cimetidine, disulfiram, fluconazole, fluoxetine, isoniazid (INH), omeprazole,
and paroxetine. Thus, measuring levels of Dilantin in the blood may be
necessary when patients begin or discontinue other medications. There appears
to an increased risk of malformations and birth defects in women taking
Dilantin . Thus Dilantin should be used in pregnancy only if the physician
feels that the potential benefit outweighs the risk. Dilantin is secreted
into breast milk. Nursing is not recommended for persons taking Dilantin .
Many varied adverse effects
can occur during Dilantin therapy including dizziness, drowsiness, difficulty
focusing (vision), unsteady gate, tiredness, abnormal involuntary movements,
nausea, vomiting, constipation, abdominal pain, and loss of appetite.
Children and young adults can develop overgrowth of the gums during long-term
therapy which requires regular treatment by a dentist. Good oral hygiene and
gum massage may reduce the risk. Rashes can occur in between 1 in 20 and 1 in
10 persons; some may be severe. Also, dark coloration of the skin may develop
Dilantin can produce unusual growth of hair in some patients. This reaction
most commonly affects the arms and legs but can also affect the trunk and face;
it may be irreversible. Various lymph node reactions have been reported with
Dilantin therapy. Lymph nodes may swell up, sometimes painfully. Dilantin may
cause serum glucose to rise. Thus, blood sugar should be monitored closely
when Dilantin is administered to patients with diabetes. Dilantin can
potentially injure the liver although this is an uncommon occurrence.
Dilantin can cause the platelet or white blood cell counts to drop,
increasing the risk of bleeding or infection, respectively. Dilantin also can
cause anemia. Because it interferes with vitamin D metabolism, Dilantin can
cause weakening of the bones (osteomalacia). Dilantin can cause sexual
dysfunction including decreased libido, impotence, and priapism (painful,
prolonged erections).
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If overdose is suspected,
contact your local poison control center or emergency room immediately.
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