Index
It is an anticonvulsant that is used in a wide variety of attacks. It is also an antiarrhythmic and a muscle relaxant.
The mechanism of therapeutic action is unclear, although several cellular actions have been described that include effects on ion channels, active transport, and general membrane stabilization.
The mechanism of its muscle relaxant effect seems to imply a reduction in the sensitivity of the muscle spindles to stretch.
Spain has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other medications.
Pharmacology of Epamin
Spain is a medication that may be useful in the treatment of epilepsy. The leading site of action seems to be the motor cortex, where the spread of seizure activity is inhibited.
It reduces the maximum activity of the brainstem centers responsible for the tonic phase of tonic-clonic seizures.
This medicine dampens the unwanted and uncontrolled brain activity seen in seizures by reducing the electrical conductance between brain cells.
It lacks the sedative effects associated with phenobarbital. There are some indications that phenytoin has other effects, including the control of anxiety and mood stabilization, although it has never been approved for these purposes by the FDA.
Warning
Patients taking Epamin should strictly follow the prescribed dosage regimen and inform the physician of any clinical condition. It is impossible to take Epamin orally as prescribed, e.g., during surgery, etc.
Patients should also be warned about using other drugs or alcoholic beverages without consulting their doctor.
Patients should be instructed to call their doctor if a rash develops.
The importance of good dental hygiene should be emphasized to minimize the development of gingival hyperplasia and its complications.
Do not use Epamin capsules that are discolored.
Interactions
Many medications can increase or decrease phenytoin levels. Determinations of serum phenytoin levels are beneficial when possible drug interactions are suspected.
Increased levels of serum phenytoin: high alcohol intake, amiodarone, chloramphenicol, chlordiazepoxide, diazepam, dicumarol, disulfiram, estrogens, H 2 -antagonists, halothane, isoniazid, methylphenidate, phenothiazines, phenylbutazone, salicylates, succinimides, sulfonamides, tolbutamide, trazodone.
Decrease in serum phenytoin levels: carbamazepine, chronic alcohol abuse, reserpine, and sucralfate. The Moban brand of molindone hydrochloride contains calcium ions that interfere with the absorption of phenytoin.
The ingestion times of phenytoin preparations and calcium-containing antacids should be staggered in patients with low levels of serum phenytoin to avoid absorption problems.
Other medications that can increase or decrease serum phenytoin levels: are phenobarbital, sodium valproate, and valproic acid. Similarly, the effect of phenytoin on serum levels of phenobarbital, valproic acid, and sodium valproate is unpredictable.
Tricyclic antidepressants: although it is not an actual pharmacological interaction, tricyclic antidepressants can precipitate seizures in susceptible patients, and it may be necessary to adjust the dose of phenytoin.
Medications whose efficacy is affected by phenytoin include corticosteroids, coumarin anticoagulants, digitoxin, doxycycline, estrogens, furosemide, oral contraceptives, quinidine, rifampicin, theophylline, and vitamin D.
Laboratory interaction test
Phenytoin can cause a decrease in serum levels of protein-bound iodine (PBI). It can also produce lower than average values for dexamethasone or metyrapone tests.
Phenytoin can cause increased serum glucose, alkaline phosphatase, and gamma-glutamyl transpeptidase (GGT) levels.
Side effects
Seek emergency medical attention if you have any of these symptoms of an allergic reaction:
- Rochas
- Difficult breathing
- Swelling of your face, lips, tongue, or throat.
You are more likely to have an allergic reaction if you are African American.
If you have a new symptom, tell your doctor. As changes in behavior and mood, panic attacks, anxiety, insomnia, irritability, you feel agitated, restless, aggressive, depressed, or have thoughts of suicide.
Contact your doctor immediately if you present:
- Fever, swollen glands, sore throat, shortness of breath, painful sores in the mouth, and sores around the eyes.
- Skin rash, bruising or easy bleeding, severe weakness.
- Severe muscle pain.
- Nausea, vomiting, pain in the upper part of the stomach, loss of appetite, dark urine, and jaundice (yellowing of the skin or eyes).
- Pain in the bones (especially in the hips, legs, or lower back), problems walking.
- Severe skin reaction, sore throat, fever, swelling of the tongue or face, pain in the skin, burning eyes. Also, if you have a red-colored rash that spreads (especially on your upper body or face) and causes flaking and blistering.
Who should not take Epamin?
You should not use Epamin if you take delavirdine (Rescriptor) or are allergic to Epamin or similar medicines such as ethotoin (Peganone), fosEpamin, etc.
To make sure Epamin is safe for you, tell your doctor if you have:
- Liver disease
- Diabetes.
- Depression.
- A history of suicidal thoughts or actions.
- A deficiency of vitamin D or any other condition causes bone thinning.
- Porphyria (a genetic enzyme disorder that causes symptoms that affect the skin or nervous system).
- If you drink large amounts of alcohol.
How should I take Epamin?
Follow all instructions on your prescription label. Do not take this medication in larger or smaller amounts or longer than recommended.
Do not crush, chew, break or open an extended-release capsule. Drink it whole.
Call your doctor to get a new prescription. Shake the oral suspension (liquid) well just before taking a dose.
Measure the liquid medication with the dosing syringe, a special measuring spoon, or a medicine cup if you do not have a dose measurement device, request one from your pharmacist.
While using Epamin, you may need frequent blood tests. You may also need a blood test when switching from one form of Epamin to another.
Visit your doctor regularly. If you take Epamin to treat seizures, you should not stop using Epamin suddenly, even if you feel well.
