Page 47 - Naplex Q&A 2025 Version

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and older, who are at high risk of developing these Gingival hyperplasia is the principal side effect of
infections due to being severely Dilantin. It refers to bleeding from, and
immunocompromised, such as hematopoietic stem enlargement of the gums. The symptoms usually
cell transplant (HSCT) recipients with graft-versus- begin to appear within 24 weeks from the initiation
host disease (GVHD) or those with hematologic of therapy. It may cause gingivitis or inflammation
malignancies with prolonged neutropenia from of gums. The chances of gingivitis are higher in
chemotherapy. It is also indicated for the treatment younger than in older patients. Lupus
of oropharyngeal candidiasis, including erythematosus and ataxia have also been reported
oropharyngeal candidiasis refractory to itraconazole with the treatment of Dilantin.
and/or fluconazole.
50.(b) Nystagmus (continuous uncontrolled rolling,
Each dose of Noxafil should be administered during back and forth movement of eye), ataxia
or immediately (i.e. within 20 minutes) following a (unsteadiness; patient can’t walk steadily),
full meal. In patients who cannot eat a full meal, dysarthria (stuttering or slurred speech) and
each dose of Noxafil should be administered with a lethargy (weakness) are reported side effects of
liquid nutritional supplement or an acidic Dilantin (Phenytoin).
carbonated beverage. For patients who cannot eat
a full meal or tolerate an oral nutritional 51.(a) Depakote (Sodium valproate) or Depakene
supplement or an acidic carbonated beverage, (Valproic acid) is classified as an antiepileptic drug.
alternative antifungal therapy should be considered It generally increases the concentration of GABA
or patients should be monitored closely for (Gamma Amino Butyric Acid). GABA is an inhibitory
breakthrough fungal infections. neurotransmitter and hence by increasing the
concentration of it, antiepileptic action is produced.
A pharmacist should instruct a patient to shake
Noxafil oral suspension well before use. The oral Depakote (Sodium valproate) or Depakene (Valproic
suspension shall be stored at controlled room acid) is indicated as monotherapy and adjunctive
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temperature (15 C and 30 C). Arrhythmias, QT therapy in the treatment of patients with complex
prolongation and liver toxicity are reported side partial seizures that occur either in isolation or in
effects of the drug. association with other types of seizures. It is also
indicated for use as sole and adjunctive therapy in
49. (e) Dilantin (Phenytoin) is classified as an the treatment of simple and complex absence
antiepileptic drug. It is a hydantoin derivative. seizures, and adjunctively in patients with multiple
seizure types that include absence seizures.
Parenteral Dilantin (Phenytoin) is indicated for the
control of generalized tonic-clonic status Simple absence is defined as very brief clouding of
epilepticus, and prevention and treatment of the sensorium or loss of consciousness
seizures occurring during neurosurgery. Parenteral accompanied by certain generalized epileptic
Dilantin should be used only when oral Dilantin discharges without other detectable clinical signs.
administration is not possible. Complex absence is the term used when other signs
are also present.
Oral Dilantin (Phenytoin) is indicated for the control
of tonic-clonic (grand mal) and psychomotor It is also indicated for the treatment of the manic
(temporal lobe) seizures. episodes associated with bipolar disorder and
prophylaxis of migraine headaches.
It is available in tablet, chewable tablet, oral
suspension and injection dosage forms. The Patients should initiate therapy at 10 to 15
recommended dose of the drug is 125 to 250 mg mg/kg/day. The dosage should be increased by 5 to
three times a day. 10 mg/kg/week to achieve optimal clinical

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