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Mechanism of Action Blocks voltage-gated sodium channels Prolongs the inactivated state of the channel Prevents rapid, repetitive neuronal firing Indications Focal (partial) seizures Generalized tonic-clonic seizures Status epilepticus (IV phenytoin / fosphenytoin for prevention of recurrence) Not effective for absence seizures Pharmacokinetics (Exam Favorite) Non-linear (zero-order) kinetics at therapeutic doses Small dose increase large rise in plasma level Highly protein-bound (albumin) Adverse Effects Dose-Related Nystagmus Ataxia Diplopia Sedation Chronic Use Gingival hyperplasia Hirsutism Acne, coarse facial features Peripheral neuropathy Osteomalacia ( vitamin D) Serious Stevens-Johnson syndrome Bone marrow suppression Teratogenicity (fetal hydantoin syndrome) Contraindications / Cautions Pregnancy (use only if benefits outweigh risks) Liver disease Hypoalbuminemia Drug Interactions Potent enzyme inducer (CYP450) efficacy of: Oral contraceptives Warfarin Steroids Interacts with many AEDs Monitoring Serum phenytoin levels Liver function tests Signs of toxicity Gingival hyperplasia = phenytoin Zero-order kinetics Avoid in absence seizures Strong enzyme inducer To view or add a comment, sign in #Prednisolone Drug Class: Corticosteroid (Glucocorticoid) Indications / Uses: Allergic disorders (asthma, allergic rhinitis) Autoimmune diseases (rheumatoid arthritis, lupus) Inflammatory conditions Dermatological disorders Adrenal insufficiency Prevention of transplant rejection Mechanism of Action (MOA): Binds to intracellular glucocorticoid receptors Modulates gene transcription in the nucleus Decreases production of inflammatory mediators (prostaglandins, cytokines) Suppresses immune and inflammatory responses Dose: Dose varies based on indication and severity Usually given once daily or in divided doses (oral) Adverse Effects: Weight gain & fluid retention Hyperglycemia Hypertension Osteoporosis (long-term use) Increased risk of infections Gastric irritation Contraindications / Caution: Systemic fungal infections Uncontrolled diabetes or hypertension Peptic ulcer disease Abrupt discontinuation after long-term therapy Drug Interactions: NSAIDs risk of GI ulcer/bleeding Antidiabetic drugs glycemic control Clinical Pearl: Never stop prednisolone abruptly after long-term use

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