Therapeutic Actions and Contraindications of Hydantoins

What is the primary therapeutic action of hydantoins?

Hydantoins can be safely used during pregnancy without any risks to the fetus.

What should women of childbearing age do while taking hydantoins?

Hydantoins reduce the __________, muscular, and emotional responses to stimulation.

Which patient group requires caution when using hydantoins?

Discontinuing antiepileptic drugs can potentially lead to status epilepticus.

Match the following contraindications and cautions with the correct descriptions:

What cardiovascular considerations should be taken when administering fosphenytoin intravenously?

Which of the following contraindications is NOT associated with phosphenytoin?

The most common adverse effects of phosphenytoin include increased energy and alertness.

Name one severe adverse effect that can be caused by hydantoins.

Patients taking hydantoins should be advised against consuming __________ while undergoing treatment.

Match the following adverse effects with their corresponding descriptions:

Therapeutic Actions of Hydantoins

Stabilize nerve membranes in the CNS by influencing ionic channels.
Decrease excitability and hyperexcitability to stimulation.
Reduce conduction through nerve pathways, lowering tonic-clonic, muscular, and emotional responses.

Contraindications and Cautions

Contraindicated for patients allergic to hydantoins to prevent hypersensitivity reactions.
Associated with specific birth defects; caution in pregnancy and lactation.
Risk of seizures outweighing fetal risk may justify continued use in pregnant women.
Discontinuing antiepileptic drugs may lead to status epilepticus, increasing risk for both mother and fetus.
Women of childbearing age should use barrier contraceptives while taking these medications.
Educate and counsel patients if pregnancy occurs during treatment.
Exercise caution in elderly, debilitated patients, and those with renal or liver impairment.
Hepatic impairment increases toxicity risk from phenytoin.
Careful monitoring required for patients receiving intravenous fosphenytoin due to cardiovascular concerns.
Avoid use in patients with coma, depression, or psychoses due to potential for exacerbation.

Adverse Effects

Common effects include CNS depression symptoms: depression, confusion, drowsiness, lethargy, fatigue.
Gastrointestinal effects: constipation, dry mouth, anorexia.
Cardiac effects: arrhythmias, blood pressure changes.
Urinary retention and loss of libido also noted.
Severe adverse effects include liver toxicity, bone marrow suppression, gingival hyperplasia, and serious dermatological reactions (e.g., Stevens-Johnson syndrome).
Risk of malignant lymphoma linked to cellular toxicity.
Increased CNS depression risk when hydantoins are combined with alcohol; patients should refrain from alcohol intake.
Consult drug references before adding or withdrawing any medications in patients on hydantoins.

This quiz covers the therapeutic actions of hydantoins, focusing on their effects on nerve membranes and excitability. It also addresses important contraindications and cautions for their use, particularly in pregnant women and special populations. Test your knowledge on the implications of hydantoin use and safety considerations.