NEWS HIGHLIGHTS
Published Studies Related to Dilantin Kapseals (Phenytoin)
Safety and feasibility of switching from phenytoin to levetiracetam monotherapy for glioma-related seizure control following craniotomy: a randomized phase II pilot study. [2009.07]
Seizures are common in patients with gliomas, and phenytoin (PHT) is frequently used to control tumor-related seizures. PHT, however, has many undesirable side effects (SEs) and drug interactions with glioma chemotherapy...
Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial. [2009.03.16]
BACKGROUND: Convulsive status epilepticus demands urgent and appropriate management with anticonvulsants. Intravenous diazepam is an established drug in the management of convulsive status epilepticus in adults as well as in children. The efficacy of intravenous lorazepam has not been well established in children. OBJECTIVE: To determine whether intravenous lorazepam is as efficacious as diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children. STUDY DESIGN: Randomized controlled trial... CONCLUSION: Lorazepam is as efficacious and safe as diazepam-phenytoin combination. We recommend use of lorazepam as a single drug to replace the two drug combination of diazepam-phenytoin combination to control the initial seizure in pediatric convulsive status epilepticus.
Ineffectiveness of folic acid supplementation against phenytoin-induced decrease in salivary immunoglobulin A concentration of epileptic patients. [2008]
CONCLUSIONS: According to these results, folic acid supplementation does not seem to have the efficacy to ameliorate phenytoin-induced salivary IgA hyposecretion. (c) 2008 S. Karger AG, Basel
Topical phenytoin solution for treating pressure ulcers: a prospective, randomized, double-blind clinical trial. [2007.11]
STUDY DESIGN: Prospective, randomized, double-blind clinical trial.Objectives:To evaluate the efficacy of topical phenytoin solution in treating pressure ulcers among patients with spinal cord disorders and to evaluate the systemic absorption of topical phenytoin. SETTING: Physical Medicine and Rehabilitation Unit, Christian Medical College, Vellore, India... CONCLUSIONS: Phenytoin solution is a safe topical agent that accelerates healing of pressure ulcers. However, its efficacy is only slightly more than normal saline treatment.
Randomized study of intravenous valproate and phenytoin in status epilepticus. [2007.09]
CONCLUSION: IV VA is as effective as IV phenytoin. It is easy to use, better tolerated and can be used as an alternative to IV phenytoin in patients of benzodiazepine refractory SE, especially in patients of cardio-respiratory disease. The better outcome in patients having shorter duration of SE (<2h) suggests need of immediate treatment.
Clinical Trials Related to Dilantin Kapseals (Phenytoin)
Phenytoin as a Neuroprotective Agent Against Corticosteroid-Induced Functional Imaging Changes [Recruiting]
The purpose of this research is to determine if patients who receive phenytoin (also
commonly known as Dilantin) before taking corticosteroids will show less memory impairment
and hypomanic symptoms (feelings of agitation, overexcitement or hyperactivity) than those
receiving placebo (an inactive substance). This research also seeks to determine if
patients taking phenytoin before corticosteroids show more activity in the area of the brain
involved with memory than those receiving placebo.
This research is being done because increased levels of cortisol (the body's natural
corticosteroid) in the body are frequently associated with forgetfulness, and interventions
that may prevent or reverse this effect are of great importance.
Phenytoin and Driving Safety [Recruiting]
Automobile driving is a crucial aspect of everyday life, yet vehicular crashes represent a
serious public health problem. Patients with epilepsy are at elevated risk for automobile
crashes, causing great personal suffering and financial costs to society. Most collisions
involving epileptic drivers are not seizure related but may instead result from cognitive
effects upon driving performance of epilepsy and antiepileptic drugs (AEDs). Several million
American drivers take AEDs for treatment of medical conditions besides epilepsy and may also
be at risk for cognitive impairments that can reduce driving performance. Empirical evidence
of the effects of AEDs on driving performance would enable development of driving guidelines
that could lower the risk of injurious motor vehicle collisions; however, this evidence is
currently lacking. The broad goal of our project is to determine the specific effects of the
most commonly utilized AED, phenytoin, by assessing driving performance and cognitive
abilities in neurologically normal volunteers taking phenytoin in a randomized,
double-blind, placebo-controlled, crossover study. Our proposed experiments will assess: (1)
cognitive functions using standardized neuropsychological tests (of attention, perception,
memory, and executive functions), (2) driving performance during phenytoin and placebo
administration, and (3) the effects of phenytoin-related cognitive performance upon driving
performance. To measure driving performance, we will use a state-of-the-art fixed-base
interactive driving simulator that allows us to observe driver errors in an environment that
is challenging yet safe for the driver and tester, under conditions of optimal stimulus and
response control. The results of this study of 30 drivers treated with phenytoin and placebo
will increase the understanding of the role of AED-related cognitive impairment on driving
safety errors. A better understanding of the impact of AEDs upon driving performance is
necessary to rationally develop interventions that could help prevent crashes by drivers
treated with AEDs.
Phenytoin and Multidose Activated Charcoal [Recruiting]
Phenytoin is a medicine used to treat seizures. If too much is taken, patients have ill
effects including sleepiness, unsteady gait, and eye problems. The amount of drug in their
system can be measured in their blood. Charcoal is a medicine that can absorb phenytoin. We
want to see if giving multiple doses of charcoal will quicken the removal of phenytoin from
the blood. This is theorized to occur as charcoal absorbs phenytoin from across the
intestines and then is secreted in the stool. Patients will be selected to receive either
charcoal in multiple doses or no charcoal and their serum levels will be drawn repeatedly to
follow their level. The different groups will then be compared to see if multidose charcoal
does indeed shorten the half-life of phenytoin in the blood.
Evaluation of CYP2C9 Activity [Recruiting]
The use of phenytoin metabolism to produce S-HPPH accounts for more than 85% of its
metabolism. This metabolic pathway is mediated by the activity of CYP2C9.
The purpose of the present study is:
1. To confirm the use of phenytoin metabolic ratio as a marker of CYP2C9 activity
2. To correlate phenytoin metabolic ratio with CYP2C9 genotype
3. To study the frequency distribution of CYP2C9 activity in-vivo
Evaluating the Transporter Protein Inhibitor Probenecid In Patients With Epilepsy [Recruiting]
The study is being done to understand why some patients with epilepsy (disease of recurrence
of seizures) do not respond very well to drug treatment with anticonvulsants.
Despite the availability of many anticonvulsants, about 30% of patients with epilepsy are
resistant to them. The cause of the resistance is not clear, but one of the reasons could be
an increased amount of proteins in the cells of the body called transporter proteins.
Transporter proteins are a group of proteins that help to defend the body against toxins,
including drugs, by pumping them out of the cells. Studies have shown that the number of
transporter proteins is higher in the parts of the brain that trigger seizures when compared
to other parts of the brain.
Studies in animals have shown that taking an anticonvulsant with an inhibitor (meaning "to
stop" or "to reduce") of a transporter protein can increase the concentration of that
anticonvulsant inside the brain cells. The main purpose of the study is to determine if
taking an anticonvulsant and a transporter protein inhibitor will change the brain
concentration of the anticonvulsant.
In this study, a single dose of phenytoin (Dilantin® is a brand name anticonvulsant which
has phenytoin as its active ingredient), a commonly used anticonvulsant, will be given once
by itself, and then will be given a separate time with a single (i. e. one time only) dose of
probenecid. Probenecid, a medicine used commonly to treat gout (a disease of increased uric
acid), is known to be an inhibitor of transporter proteins. The study will use
electroencephalogram or EEG (recording of brain wave activities) to determine if the EEG
pattern when probenecid is given, will be different from the EEG pattern when phenytoin is
given alone. This will suggest that probenecid has affected the brain concentration of
phenytoin.
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