Phenytoin (Dilantin) Nursing Considerations

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Kara Tarr
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Outline

Generic Name

phenytoin

Trade Name

Dilantin

Indication

tonic clonic seizures, arrhythmias, neuropathic pain

Action

interferes with ion transport, shortens action potentials and decreases automaticity blocks sustained
high frequency repetitive firing of action potentials.

Therapeutic Class

antiarrhythmics, anticonvulsants

Pharmacologic Class

hydantoins

Nursing Considerations

• monitor serum phenytoin levels
• therapeutic levels 10-20 mcg/mL
• use cautiously in all patients
• can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven’s Johnson syndrome
• concurrent administration of enteral feedings may decrease absorption
• monitor for hypersensitivity
• assess seizures
• assess hemodynamics

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Transcript

Okay, let’s take a look at the drug. Feni toin also known as Dilantin. This is an oral and IV medication, as you can see here. So the therapeutic class Afeni toin is an anticonvulsant. And remember, this is how the truck works in the body. The pharmacologic class, or the chemical effect of phenytoin is a high Antoine. So phenytoin works by interfering with ion transport. It shortens the action potential and decreases automaticity. It blocks sustained high frequency, repetitive firing of action potentials, which is why we use it for tonic chronic seizures, arrhythmias, and for neuropathic pain side effects associated with Venito on our Dilantin are hypotension, tachycardia, nausea, and rash. 

So a few nursing considerations for Fone be sure to monitor the patient’s Dilantin or PHN toin levels. The therapeutic range being between 10 and 20 MCGs per ML use caution with concurrent administrations administration of Venter feedings, because they may decrease abs absorption Venito may cause suicidal thoughts, ataxia, extra pyramidal symptoms, arrhythmias, gingival hyperplasia, which is that overgrowth of the gums, a GRA cytosis and also Steven’s Johnson syndrome. Be sure to assess seizure activity in your patient, as well as their hemodynamics while on this medication, and be sure to teach your patient to report symptoms as well as seizure activity to their provider. So guys, the pharmacokinetics of Fone are super complicated. It really doesn’t follow normal drug metabolism and the level drawn. It is not necessarily reflective of the level of Fone in the patient’s blood, because it is a highly protein bound drug. So phenytoin level should be adjusted based on albumin level and renal function before the drug drug is actually adjusted. Guys, I would recommend, um, anytime you have a question regarding drugs that you contact the pharmacy, wherever it is that you work. So it is okay to not know every possible thing about a medication, as long as you know where to get the information. So I personally love the pharmacist at my place of employment, and I call them all the time if I have questions and there’s absolutely nothing wrong with that, that’s it for Afeni toin or Dilantin now go out and be your best self today and as always happy nursing.

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Exam 2 10/22/25

Concepts Covered:

  • Hematologic Disorders
  • Terminology
  • Central Nervous System Disorders – Brain
  • Medication Administration
  • Neurologic and Cognitive Disorders
  • Peripheral Nervous System Disorders
  • Intraoperative Nursing
  • Acute & Chronic Renal Disorders
  • Immunological Disorders
  • Emergency Care of the Neurological Patient
  • Studying
  • Neurological Emergencies
  • Respiratory Disorders
  • Oncology Disorders
  • Oncologic Disorders
  • Test Taking Strategies
  • Cognitive Disorders
  • Documentation and Communication
  • Legal and Ethical Issues
  • Communication
  • Basics of NCLEX
  • Preoperative Nursing
  • Substance Abuse Disorders
  • Hematologic Disorders
  • Emotions and Motivation
  • Labor Complications
  • Statistics
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient

Study Plan Lessons

Hematology Module Intro
Hematology Oncology & Immunology Terminology
Hematology/Oncology/Immunology Course Introduction
Benztropine (Cogentin) Nursing Considerations
Blood Brain Barrier (BBB)
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Neuro Disorders Module Intro
Nursing Care and Pathophysiology for Parkinsons
Nursing Care Plan (NCP) for Parkinson’s Disease
Anticonvulsants
Barbiturates
Ferrous Sulfate (Iron) Nursing Considerations
Epoetin (Epogen) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Nursing Care and Pathophysiology for Seizure
Phenobarbital (Luminal) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Disorders for Certified Emergency Nursing (CEN)
Seizure Documentation Nursing Mnemonic (TDOC)
Seizure Management in the ER
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Stroke Nursing Care (CVA)
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Hematocrit (Hct) Lab Values
Oncology Module Intro
Oncology Important Points
Oncology nurse
Pediatric Oncology Basics
12 Points to Answering Pharmacology Questions
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Documentation Basics
Fundamentals Course Introduction
How to Write a Nursing Care Plan
How to Write A Nursing Progress Note
How to Take Nursing Report
Communicating with Providers
Communicating With Providers
Communicating With Other nurses
Giving Handoff Report
Handoff Report
Health Assessment Course Introduction
Head to Toe Nursing Assessment (Physical Exam)
Intro to Health Assessment
Introduction to Health Assessment
Iron Deficiency Anemia
Maslow’s Hierarchy of Needs in Nursing
Alkylating Agents
Antimetabolites
Antineoplastics
Blood Transfusions (Administration)
Epoetin Alfa
Ferrous Sulfate (Iron) Nursing Considerations
Hematocrit (Hct) Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Leukemia
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Multiple Myeloma
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Thrombocytopenia
Oncology Important Points
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Sickle Cell Anemia
Sinus Tachycardia
Thrombocytopenia
Total Iron Binding Capacity (TIBC) Lab Values
Vitamin B12 Lab Values
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)