Saturday, August 28, 2010

Can phenytoin ( anti-convalsant ) cause Diabetes Mellitus as a side effect

can phenytoin ( anti-convalsant ) cause Diabetes Mellitus as a side effect ?
i know Na-Valproate ( also anti-convalsant) can cause pancreatitis and so cause DM , what about phenytoin ?
Diabetes - 3 Answers
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1 :
I have never heard of this, but diabetics on phenytoin have to be closely monitored because it can cause blood glucose levels to rise http://www.medicinenet.com/phenytoin/article.htm
2 :
Side-effects: At therapeutic doses, phenytoin produces horizontal gaze nystagmus, which is harmless but occasionally tested for by law enforcement as a marker for drunkenness (which can also produce nystagmus). At toxic doses, patients experience sedation, cerebellar ataxia, and ophthalmoparesis, as well as paradoxical seizures. Idiosyncratic side effects of phenytoin, as with other anticonvulsants, include rash and severe allergic reactions. There is some evidence that phenytoin is teratogenic, causing what Smith and Jones in their Recognizable Patterns of Human Malformation called the fetal hydantoin syndrome. There is some evidence against this. One blinded trial >needs documentation!<Italic text asked physicians to separate photographs of children into two piles based on whether they showed the so-called characteristic features of this syndrome; it found that physicians were no better at diagnosing the syndrome than would be expected by random chance, calling the very existence of the syndrome into question. Data now being collected by the Epilepsy and Antiepileptic Drug Pregnancy Registry may one day answer this question definitively. Phenytoin may accumulate in the cerebral cortex over long periods of time, as well as causing atrophy of the cerebellum when administered at chronically high levels. Despite this, the drug has a long history of safe use, making it one of the more popular anti-convulsants prescribed by doctors, and a common "first line of defense" in seizure cases. Phenytoin also commonly causes gingival hyperplasia due to folate deficiency. Due to patent expiration, phenytoin is available in generic form and several branded forms at relatively low cost, making it one of the more affordable seizure control medications. It is available in extended release capsules and injectable forms, though the injectable formulation is rapidly losing ground to fosphenytoin. Some generic formulations of phenytoin have been felt to be less reliable with respect to time-release than their branded counterparts. In some cases, this can be related to complications which arise between the alternative protein bond release mechanisms used in the generic versions, and those individuals with high metabolic rates.
3 :
No, diabetes is not a recognised side effect of phenytoin, that said it can affect blood glucose levels which need to be monitored whilst a person is taking phenytoin.

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