Latest & greatest articles for phenytoin

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Top results for phenytoin

21. Phenobarbitone versus phenytoin monotherapy for partial onset seizures and generalized onset tonic-clonic seizures.

Phenobarbitone versus phenytoin monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. BACKGROUND: Worldwide, phenytoin and phenobarbitone are commonly used antiepileptic drugs. They are more likely to be used in the developing world than the developed world, primarily because they are inexpensive. The aim of this review is to summarise data from existing trials comparing phenytoin and phenobarbitone. OBJECTIVES: To review the effects of phenobarbitone compared (...) to phenytoin when used as monotherapy in patients with partial onset seizures or generalized tonic-clonic seizures with or without other generalized seizure types. SEARCH STRATEGY: Our search strategy has included: a) MEDLINE 1966 to 1998, b) the controlled trials register of the Cochrane Library, c) hand-searching relevant journals, d) the pharmaceutical industry, e) researchers in the field. SELECTION CRITERIA: Randomized controlled trials in children or adults with partial onset seizures or generalized

Cochrane2001

22. Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures.

Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. BACKGROUND: Phenytoin and valproate are commonly used antiepileptic drugs. It is generally believed that phenytoin is more effective for partial onset (simple partial, complex partial and secondary generalized tonic-clonic seizures) seizures whilst valproate is more effective in generalized onset seizures (generalized tonic-clonic seizures, absence, myoclonus) although (...) there is no evidence from randomized controlled trials to support this belief. The use of individual patient data meta-analysis enabled us to examine time to event outcomes which are important in epilepsy monotherapy trials, and also to examine treatment-covariate interactions. OBJECTIVES: To review the best evidence comparing phenytoin and valproate when used as monotherapy in subjects with partial onset seizures, or generalized onset tonic-clonic seizures with or without other generalized seizure types. SEARCH

Cochrane2001

23. Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department

Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Cost-minimization analysis of phenytoin and fosphenytoin in the emergency department Touchette D R, Rhoney D H Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) drug treatments. The effectiveness, in terms of stopping seizures, was assumed to be equal for both the drugs. Patients in status epilepticus, and those for whom intravenous phenytoin would not be administered, were excluded from the analysis. Outcomes assessed in the review The outcomes assessed in the review, and used as input parameters in the decision model, were mainly the clinical data on the rates of several adverse events. These were collected prospectively and retrospectively from

NHS Economic Evaluation Database.2000

24. Magnesium sulphate versus phenytoin for eclampsia.

Magnesium sulphate versus phenytoin for eclampsia. BACKGROUND: A number of different anticonvulsants are used to control eclamptic fits and to prevent further seizures. OBJECTIVES: The objective of this review was to assess the effects of magnesium sulphate compared with phenytoin when used for the care of women with eclampsia. Magnesium sulphate is compared with diazepam and with lytic cocktail (in preparation) in other Cochrane reviews. SEARCH STRATEGY: We searched the Cochrane Pregnancy (...) and Childbirth trials register and the Cochrane Controlled Trials Register, Issue 3 1999. SELECTION CRITERIA: Randomised trials comparing magnesium sulphate (intravenous or intramuscular administration) with phenytoin for women with a clinical diagnosis of eclampsia. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data extraction was done by two reviewers. MAIN RESULTS: Four trials involving 823 women were included. The trials were of good quality. Magnesium sulphate was associated

Cochrane2000

25. Phenobarbital compared with phenytoin for the treatment of neonatal seizures.

Phenobarbital compared with phenytoin for the treatment of neonatal seizures. 10441604 1999 08 12 1999 08 12 2013 11 21 0028-4793 341 7 1999 Aug 12 The New England journal of medicine N. Engl. J. Med. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. 485-9 Seizures occur in 1 to 2 percent of neonates admitted to an intensive care unit. The treatment is usually with either phenobarbital or phenytoin, but the efficacy of the two drugs has not been compared directly (...) . From 1990 to 1995, we studied 59 neonates with seizures that were confirmed by electroencephalography. The neonates were randomly assigned to receive either phenobarbital or phenytoin intravenously, at doses sufficient to achieve free plasma concentrations of 25 microg per milliliter for phenobarbital and 3 microg per milliliter for phenytoin. Neonates whose seizures were not controlled by the assigned drug were then treated with both drugs. Seizure control was assessed by electroencephalographic

NEJM1999

26. An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy

An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy An economic appraisal of carbamazepine, lamotrigine, phenytoin and valproate as initial treatment in adults with newly diagnosed epilepsy Heaney D C, Shorvon S D, Sander J W Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Four drugs used in monotherapy during the first two years of treatment for newly diagnosed patients with epilepsy were compared. These were Carbamazepine (CBZ), Phenytoin (PHT), Valproate (VPA) and Lamotrigine (LTG). Type

NHS Economic Evaluation Database.1998

27. A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments

A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments A pharmacoeconomic evaluation of intravenous fosphenytoin (Cerebyx) versus intravenous phenytoin (Dilantin) in hospital emergency departments Marchetti A, Magar R, Fischer J, Sloan E, Fischer P Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Intravenous (IV) fosphenytoin (Cerebyx) versus IV phenytoin (Dilantin) in patients needing an IV loading dose of phenytoin for the treatment or prevention of seizures in acute care settings. Type

NHS Economic Evaluation Database.1996

28. Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy.

Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. 8601999 1996 05 09 1996 05 09 2015 06 16 0140-6736 347 9003 1996 Mar 16 Lancet (London, England) Lancet Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. 709-13 The medical treatment of childhood epilepsy is largely influenced by clinical trials in adult (...) generalisation, were randomly allocated treatment with phenobarbitone, phenytoin, carbamazepine, or sodium valproate. The protocol was designed to conform to standard clinical practice. Efficacy was assessed by time to first seizure after the start of treatment and time to achieving 1-year remission. The overall outcome with all four drugs was good. 20% of children remained free of seizures and 73% had achieved 1-year remission by 3 years of follow-up. We found no significant differences between the drugs

Lancet1996

29. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia.

A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. 7791836 1995 07 27 1995 07 27 2013 11 21 0028-4793 333 4 1995 Jul 27 The New England journal of medicine N. Engl. J. Med. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. 201-5 Magnesium sulfate is used widely to prevent eclamptic seizures in pregnant women with hypertension, but few studies have compared the efficacy of magnesium sulfate with that of other drugs. Anticonvulsant (...) prophylaxis with phenytoin for eclampsia has been recommended, but there are virtually no data to support its efficacy. Our objective was to compare magnesium sulfate with phenytoin in preventing seizures in hypertensive women during labor. We randomly assigned women with hypertension who were admitted for delivery to receive either magnesium sulfate or phenytoin. The magnesium sulfate regimen consisted of a 10-g intramuscular loading dose followed by a maintenance dose of 5 g given intramuscularly every

NEJM1995

30. Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group.

Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group. 1608407 1992 07 21 1992 07 21 2013 11 21 0028-4793 327 3 1992 Jul 16 The New England journal of medicine N. Engl. J. Med. Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa. Epidermolysis Bullosa Study Group. 163-7 Recessive dystrophic epidermolysis bullosa is an uncommon, severely disabling, heritable disorder characterized by abnormal fragility of the skin (...) . Open trials have suggested that phenytoin is an effective treatment, and this therapy is now widely used. To determine the efficacy of phenytoin in the treatment of recessive dystrophic epidermolysis bullosa, we performed a randomized, double-blind, placebo-controlled, crossover trial in 36 patients. Each treatment was given for five to seven months, separated by a two-month period. We measured the total number of blisters and erosions on the entire body, the size of three plaques containing

NEJM1992

31. Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures.

Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures. 1995974 1991 03 25 1991 03 25 2016 10 17 0098-7484 265 10 1991 Mar 13 JAMA JAMA Neurobehavioral effects of phenytoin prophylaxis of posttraumatic seizures. 1271-7 In order to determine potential negative neurobehavioral effects of phenytoin given to prevent the development of posttraumatic seizures, 244 subjects were randomized to phenytoin or placebo. They received neurobehavioral assessments at 1 and 12 months (...) postinjury while receiving their assigned drug and at 24 months while receiving no drugs. In the severely injured, phenytoin significantly impaired performance at 1 month. No significant differences were found as a function of phenytoin in the moderately injured patients at 1 month or in either severity group at 1 year. Patients who stopped receiving phenytoin according to protocol between 1 and 2 years improved more than corresponding placebo cases on several measures. We conclude that phenytoin has

JAMA1991

32. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures.

A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. 2115976 1990 09 06 1990 09 06 2013 11 21 0028-4793 323 8 1990 Aug 23 The New England journal of medicine N. Engl. J. Med. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. 497-502 Antiepileptic drugs are commonly used to prevent seizures that may follow head trauma. However, previous controlled studies of this practice have been inconclusive. To study further (...) the effectiveness of phenytoin (Dilantin) in preventing post-traumatic seizures, we randomly assigned 404 eligible patients with serious head trauma to treatment with phenytoin (n = 208) or placebo (n = 196) for one year in a double-blind fashion. An intravenous loading dose was given within 24 hours of injury. Serum levels of phenytoin were maintained in the high therapeutic range (3 to 6 mumol of free phenytoin per liter). Follow-up was continued for two years. The primary data analysis was performed

NEJM1990

33. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures.

Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. 3925335 1985 08 01 1985 08 01 2013 11 21 0028-4793 313 3 1985 Jul 18 The New England journal of medicine N. Engl. J. Med. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. 145-51 We conducted a 10-center, double-blind trial to compare the efficacy and toxicity of four antiepileptic (...) drugs in the treatment of partial and secondarily generalized tonic-clonic seizures in 622 adults. Patients were randomly assigned to treatment with carbamazepine, phenobarbital, phenytoin, or primidone and were followed for two years or until the drug failed to control seizures or caused unacceptable side effects. Overall treatment success was highest with carbamazepine or phenytoin, intermediate with phenobarbital, and lowest with primidone (P less than 0.002). Differences in failure rates

NEJM1985

34. Placebo-controlled study of phenobarbitone and phenytoin in the prophylaxis of febrile convulsions.

Placebo-controlled study of phenobarbitone and phenytoin in the prophylaxis of febrile convulsions. 6116084 1981 11 22 1981 11 22 2015 06 16 0140-6736 2 8247 1981 Sep 19 Lancet (London, England) Lancet Placebo-controlled study of phenobarbitone and phenytoin in the prophylaxis of febrile convulsions. 600-4 Of 138 children who had a first febrile convulsion before their second birthday, 48 were treated with phenobarbitone, 47 with phenytoin, and 43 with a placebo for 12 months. Drug levels were (...) monitored and adverse effects of the drugs were noted. Compared with placebo, phenobarbitone significantly reduced recurrences among children under 14 months old at the time of their first convulsion, but nor among older children. Phenytoin was an ineffective prophylactic agent. Ideal drug levels were difficult to maintain, and many recurrences occurred when concentrations were suboptimal. Behavioural disturbance in children taking phenobarbitone was not a serious problem. The decision to give

Lancet1981

35. Postoperative epilepsy: a double-blind trial of phenytoin after craniotomy.

Postoperative epilepsy: a double-blind trial of phenytoin after craniotomy. 6101843 1980 04 26 1980 04 26 2015 06 16 0140-6736 1 8165 1980 Feb 23 Lancet (London, England) Lancet Postoperative epilepsy: a double-blind trial of phenytoin after craniotomy. 384-6 In a double-blind trial of phenytoin for the prevention of postoperative epilepsy in craniotomy patients, epilepsy was observed in 7.9% (8/101) of patients treated with phenytoin and in 16.7% (17/102) of those receiving placebo (...) . Therapeutic drug levels were associated with a significant reduction in the frequency of epilepsy. Three-quarters of the fits occurred within a month of cranial surgery. High rates of epilepsy have been observed after cranial surgery in patients with meningioma, aneurysm, and head injury with or without intracranial clots, and routine prophylaxis with phenytoin would seem to be indicated in such patients. North J B JB Penhall R K RK Hanieh A A Hann C S CS Challen R G RG Frewin D B DB eng Clinical Trial

Lancet1980

36. One drug (phenytoin) in the treatment of epilepsy.

One drug (phenytoin) in the treatment of epilepsy. 57334 1976 07 06 1976 07 06 2015 06 16 0140-6736 1 7966 1976 May 01 Lancet (London, England) Lancet One drug (phenytoin) in the treatment of epilepsy. 923-6 Thirty-one, previously untreated, adult outpatients with idiopathic or focal grand-mal and/or focal minor seizures were treated initially with phenytoin. Serum-phenytoin concentrations were monitored to achieve an optimum range of 10-20 mug/ml if necessary. With a mean duration of follow-up (...) of 14-7 months, only three (10%) patients have required the addition of a second drug, although without the guidance of serum concentrations sixteen (54%) might have been treated with a further drug. In the optimum serum-phenytoin range only 1 grand-mal attack occurred in this series, compared with a mean pre-treatment grand-mal seizure-rate of 1-1/month. Serum phenytoin declined slowly in fourteen (45%) patients. These observations suggest that many epileptic patients could be satisfactorily

Lancet1976