Current status of diphenylhydantoin

Dreifus, Leonard S.; Watanabe, Yoshio

doi:10.1016/0002-8703(70)90018-9

Cited by 23 publications

(7 citation statements)

References 34 publications

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“…This drug is relatively safe, yet it is not without untoward effects including direct myocardial depression, peripheral vasodilatation, arrhythmia and even death. It may be useful to refer to articles reviewing the role of diphenylhydantoin in the treatment of heart disease prior to employing it to treat TCA cardiotoxicity (142,143).…”

Section: Treatment Of Toxicitymentioning

confidence: 99%

A Review of the Cardiovascular Effects and Toxicity of Tricyclic Antidepressants

Jefferson

1975

Psychosomatic Medicine

227

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The tricyclic antidepressants have potent and complex effects on the cardiovascular system, both directly and through interactions with other drugs. Through a combination of anticholinergic activity, direct myocardial depressant activity and an effect on the adrenergic neuron, they can cause a combination of arrhythmias, blood pressure abnormalities and congestive heart failure. These changes, although most common with overdose, can occur at therapeutic levels. In addition a number of drug-drug interactions can occur between the tricyclics and agents used in the treatment of cardiovascular disease, as exemplified by tricyclic antagonism of the antihypertensive effect of guanethidine. Awareness of these factors is necessary to insure proper therapeutic utilization of the tricyclics as well as to treat effectively their toxicity.

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Section: Treatment Of Toxicitymentioning

confidence: 99%

A Review of the Cardiovascular Effects and Toxicity of Tricyclic Antidepressants

Jefferson

1975

Psychosomatic Medicine

227

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“…Subsequently, phenytoin has been proved to be effective in correcting various experimental and clinical arrhythmias (see review by Dreifus & Watanabe, 1970) and has gained wide clinical use. Mexiletine (Ko 1173) is another example of a drug originally introduced as an anticonvulsant agent but in subsequent studies found to be effective in suppressing ventricular arrhythmias both in experimental animals (Allen, Kofi Ekue, Shanks & Zaidi, 1972) and in man (Talbot, Clark, Nimmo, Neilson, Julian & Prescott, 1973).…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Antifibrillatory Activity of Some Anticonvulsant Γ‐aminobutyric Acid‐transaminase Inhibitors in the Rabbit Isolated Heart: Comparison With Phenytoin and Mexiletine

Almotrefi

Baker

1980

British J Pharmacology

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IThe electrical stimulation and ventricular fibrillation thresholds were measured in the Langendorff-perfused rabbit heart by application of rectangular impulses of 3 ms duration and increasing current at frequencies of 4 and 20 Hz respectively. 2 Perfusion with either phenytoin or mexiletine produced significant dose-dependent increases in both thresholds.3 Perfusion with four anticonvulsant inhibitors of y-aminobutyric acid (GABA-transaminase, aminooxyacetic acid, y-acetylenic GABA, y-vinyl GABA and sodium valproate, up to a concentration of 20 pg/ml, had no significant effect on either threshold.4 The results suggest that these compounds, unlike phenytoin and mexiletine, are devoid of antifibrillatory activity.

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“…The effects of withdrawal of blood samples from rats on haematocrit are shown in table 4. Haematocrit values in the animals that had been treated with phenytoin together with the macrolides were not significantly different from those that were injected with phenytoin alone.…”

Section: Effect O F Blood Sample Withdrawal On Haematocritmentioning

confidence: 98%

“…It is also useful in the treatment of trigeminal neuralgia [3]. Furthermore, the drug has been shown to be effective in correcting several experimental and clinical arrhythmias [4], Phenytoin is metabolised primarily in the liver by the hepatic cytochrome P-450 en zyme system [5], Hence, any agent which is able to inhibit or induce this enzyme system may potentially interact with phenytoin. A variety of drugs such as isoniazid.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic Interactions between Erythromycin, Clarithromycin, Roxithromycin and Phenytoin in the Rat

Al-Humayyd

1997

Chemotherapy

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The effects of the macrolide antibiotics, erythromycin, clarithromycin and roxithromycin, on the pharmacokinetic profile of phenytoin were studied in rats. Animals were injected with phenytoin (100 mg/kg, i.p.) daily for 4 days and then they were given phenytoin (20 mg/kg, i.p.) alone or the same dose of phenytoin together with erythromycin (50 mg/kg, i.p.), clarithromycin (50 mg/kg, i.p.) or roxithromycin (50 mg/kg, i.p.). In another set of experiments, the same protocol was followed except that erythromycin (100 mg/kg), clarithromycin (100 mg/kg) and roxithromycin (100 mg/kg) were given by the oral route. The concentrations of phenytoin in plasma were determined using a high-performance liquid chromatographic method. The area under the curve the maximum plasma concentration and the elimination half-life (t_½) of phenytoin were significantly (p < 0.05) increased by the macrolides. In addition, the macrolides significantly (p < 0.05) reduced the level of hepatic cytochrome P-450 in the rats. These results suggest that a potentially harmful drug-drug interaction may occur if phenytoin is administered concurrently with erythromycin, clarithromycin or roxithromycin.

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Current status of diphenylhydantoin

Cited by 23 publications

References 34 publications

A Review of the Cardiovascular Effects and Toxicity of Tricyclic Antidepressants

A Review of the Cardiovascular Effects and Toxicity of Tricyclic Antidepressants

Investigation of the Antifibrillatory Activity of Some Anticonvulsant Γ‐aminobutyric Acid‐transaminase Inhibitors in the Rabbit Isolated Heart: Comparison With Phenytoin and Mexiletine

Pharmacokinetic Interactions between Erythromycin, Clarithromycin, Roxithromycin and Phenytoin in the Rat

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