What is the teratogenic effect of phenytoin?

Background: The antiepileptic drug phenytoin (PHT) is a human and animal teratogen. The teratogenicity has been linked to PHT-induced embryonic cardiac arrhythmia and hypoxic damage during a period when regulation of embryonic heart rhythm is highly dependent on a specific K(+) ion current (I(Kr)).

What does phenytoin do to fetus?

Studies have suggested that approximately 5%-10% of infants exposed to phenytoin during pregnancy will develop fetal hydantoin syndrome.

What birth defects does phenytoin cause?

The fetal hydantoin syndrome consists of pre- and postnatal growth microcephaly, developmental delay in combination with dysmorphic craniofacial features, and nail hypoplasia. Major congenital malformations associated with phenytoin include facial clefts and congenital heart disease.

What are the signs and symptoms of appendicitis?

Standard treatment is surgical removal of the appendix. Signs and symptoms of appendicitis may include: Sudden pain that begins around your navel and often shifts to your lower right abdomen The site of your pain may vary, depending on your age and the position of your appendix.

When to see a doctor for phenytoin side effects?

Call your doctor at once if you have: 1 slow or uneven heartbeats, chest pain, fluttering in your chest,… 2 any skin rash, no matter how mild; 3 fever, chills, sore throat, swollen glands; 4 red or swollen gums, mouth sores; 5 easy bruising, unusual bleeding, purple or red spots under your skin; or. 6 (more items)

What are the symptoms of an overdose of phenytoin?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of phenytoin can be fatal. Overdose symptoms may include twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing.

Is there a link between phenytoin and hydantoin syndrome?

Maternal use of anti-seizure medications such as phenytoin, which is often used to treat epileptic seizures, can result in multiple effects on the developing embryo and fetus, including fetal hydantoin syndrome. The specific amount of phenytoin ingestion required to cause the disorder has not been determined.

Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth defects that results from maternal use of the anti-seizure (anticonvulsant) drug phenytoin (Dilantin) during pregnancy. The range and severity of associated abnormalities will vary greatly from one infant to another.

Why phenytoin is contraindicated in pregnancy?

Phenytoin Pregnancy Warnings -An increased risk of congenital abnormalities (“fetal hydantoin syndrome”) has been associated with the use of phenytoin (the active metabolite of this drug) in epileptic women during pregnancy.

Which anti seizure drugs may produce teratogenicity?

The most commonly used AED were valproic acid and carbamazepine in monotherapy. The percentage of major anomaly was 6.8% in all children. Dysmorphic features and dental anomalies were observed more in children exposed especially to valproic acid.

Can phenytoin cause neural tube defects?

However, the pattern of malformations varies. Heart defects seem to dominate among children exposed to barbiturates, and to some extent phenytoin and carbamazepine, whereas neural tube defects and hypospadia are more common among offspring of mothers taking valproate during pregnancy.

What happens if folic acid is given along with phenytoin?

The supplementation of folic acid to folate-deficient patients taking phenytoin has been shown to result in lowered serum concentrations of phenytoin, and possibly loss of control of the seizure disorder.

What is phenytoin syndrome?

Medical genetics. Fetal hydantoin syndrome, also called fetal dilantin syndrome, is a group of defects caused to the developing fetus by exposure to teratogenic effects of phenytoin. Dilantin is the brand name of the drug phenytoin sodium in the United States, commonly used in the treatment of epilepsy.

Why folic acid is given with phenytoin?

Conclusions: Folic acid supplementation should be initiated each time phenytoin therapy commences because of the hypothesized cofactor mechanism, decreased adverse effects associated with folate deficiency, and better seizure control with no perturbation of phenytoin pharmacokinetics.

What is the effect of phenytoin in pregnancy?

Today, the known potential adverse effects of phenytoin on the fetus include facial clefting, vitamin K and D deficiencies, heart malformations, limb deformities, and neurologic defects.

Which of the following is not an adverse effect of phenytoin?

Side Effects Headache, nausea, vomiting, constipation, dizziness, feeling of spinning, drowsiness, trouble sleeping, or nervousness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Phenytoin may cause swelling and bleeding of the gums.

Which drug causes neural tube defects?

Some medications that are used to treat seizures, specifically valproic acid and carbamazepine, have been associated with an increased chance of having a pregnancy affected by a neural tube defect. 11-13

  • The most common neural tube defect associated with valproic acid and carbamazepine is spina bifida.
  • Can phenytoin cause B12 deficiency?

    Previous research showed that phenytoin, as enzyme inducers, can directly regulate the activity of different liver enzymes. Liver enzyme induction may cause depletion of the cofactors, including folic acid and vitamin B12.

    Are there any neurological effects of phenytoin exposure?

    The neurological effects of phenytoin exposure in utero have not been clearly established by studies, which have demonstrated conflicting results.

    When does phenytoin cause fetal hydantoin syndrome?

    When embryo or the unborn fetus expose to phenytoin, an anticonvulsant agent causes anatomical disorders, which is termed as a fetal hydantoin syndrome. This is rare symptom, as most of the time doctors avoid prescribing phenytoin to women in their childbearing age.

    Can a pregnant woman take phenytoin during pregnancy?

    It has been observed that women using antiepileptic drugs during their pregnancy have a greater risk of fetal hydantoin syndrome for a newborn. The incidence rate showed almost 10 to 30 percent of pregnant women deliver neonates with fetal hydantoin syndrome as they expose to Phenytoin during their pregnancy.