Course Summary

Expiration Date: 11/29/2027

Phenytoin indications, clinical use, and the potential for toxicity have been well-reviewed in the literature. Phenytoin is often used in combination with other types of anticonvulsant medication and classes of medications, such as benzodiazepines, for varied clinical conditions. The drug is commonly regarded as an antiepileptic agent; however, it has been used for other conditions, as well as as a prophylactic agent in neurosurgical patients, to avoid epileptic conditions. The research on phenytoin indication, use, and potential adverse outcomes focuses on the necessary balance of clinical observation and indication, laboratory data trending serum drug levels, and pharmacological guidelines guiding drug combinations and cross titrations/tapers in certain epileptic conditions to achieve medical stability.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • Pharmacological Profile
    • Mechanism of Action
    • Indications, Dosing, and Administration:
    • Dosing/Administration and Available Forms:
  • Clinical Applications and Treatment Strategies
    • Non-Emergent Seizures
    • Status Epilepticus
    • Hepatic and Renal Impairment: Dosing Adjustments
    • Geriatric Patients: Dosing Adjustments
    • Warnings and Precautions
    • Contraindications and Adverse Effects
    • Suicidal Ideation
    • Drug-Drug Interactions
    • Monitoring
    • Therapeutic Range and Target Levels:
    • Regular Monitoring Frequency:
    • Significance of Steady-State Levels:
    • Monitoring for Toxicity:
    • Laboratory Testing and Liver Function Monitoring:
    • Patient Education and Self-Monitoring
    • Pregnancy and Breastfeeding
    • Key Points
  • Case Study: Phenytoin-Induced Dyskinesia
  • Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.