Leitura clínica
Comentário
É um antiepiléptico usado para controlar as convulsões da epilepsia e a neuralgia do trigêmeo. Também é um antiarrítmico de classe Ib que foi utilizado para tratar arritmias cardíacas. Administração oral e intravenosa. É excretada no leite materno em quantidade clinicamente não significativa. (Bar-Oz 2000, Shimoyama 1998, Meyer 1988, Söderman 1988, Kaneko 1979, Rane 1974, Mirkin 1971) Não foram observados problemas clínicos nem de desenvolvimento psicomotor a longo prazo em lactentes cujas mães a tomavam. (Meador 2014 y 2010, Mirkin 1971, LIvingston 1956) Os níveis no plasma desses lactentes foram indetectáveis ou muito baixos. (Steen 1982) Uso autorizado em lactentes e recém-nascidos. Autores especialistas consideram seguro o uso desta medicação durante a amamentação (Hale, LactMed, Crettenand 2018, Briggs 2015, Schaefer 2015, Rowe 2013, Davanzo 2013, Mercadé 2012, Mintzer 2011, Harden 2009, O'Connor 2009, Pennell 2006, O'Brien 2005, Hägg 2000) . Academia Americana de Pediatria: medicação usualmente compatível com a amamentação (AAP 2001) . Lista de medicamentos essenciais da OMS: compatível com a amamentação. (WHO 2002)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 8
- Difenilhidantoína
- Fenitoína sódica
- Φαινυτοΐνη
- فينيتوئين
- Phenytoinum
- 苯妥英
- フェニトイン
- N03AB02
Marcas comerciais na fonte 40
- Alepsal Compuesto
- Arrietic
- Aurantin
- Biodan
- Comvufen
- Dalmaril
- Dantalin
- Dantoinal
- Di-Hydan
- Dialudon
- Dilantin
- Dintoina
- Diphantoine
- Diphenal
- Diphenin (Дифенін)
- Epamin
- Epanutin
- Epelin
- Epilantin
- Etoina
- Fenantoin
- Fenidantoin S
- Feniffler
- Fenital
- Fenitan
- Fenitenk
- Fenitron
- Fentoinal
- Hidantal
- Hidantina
- Hidantoina
- Hydantin
- Lehydan
- Lotoquis
- Lotoquis Simple
- Opliphon
- Phenhydan
- Phenytek
- Sinergina
- Unifenitoin
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 70 - 100 | % |
| Peso Molecular | 252 | daltons |
| Unión proteínas | 90 | % |
| Vd | 0,5 - 0,8 | l/Kg |
| pKa | 8,49 | - |
| Tmax | 1,5 - 3 / 4 - 12 | horas |
| T½ | oral: 22 (7 - 42). / iv: 7-15 | horas |
| Índice L/P | 0,2 - 0,5 | - |
| Dosis Teórica | 0,07 - 0,4 | mg/Kg/d |
| Dosis Relativa | 1,4 - 8 | % |
| Dosis Rel. Ped. | 1 - 7 | % |
Rastreabilidade
Bibliografia
- LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consultado el 16 de Abril de 2024 Texto completo (enlace a fuente original)
- Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consultado el 10 de Abril de 2024 Texto completo (enlace a fuente original)
- Crettenand M, Rossetti AO, Buclin T, Winterfeld U. [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?] Nervenarzt. 2018 Resumen
- Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
- Veiby G, Bjørk M, Engelsen BA, Gilhus NE. Epilepsy and recommendations for breastfeeding. Seizure. 2015 May;28:57-65. Resumen Texto completo (enlace a fuente original)
- Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
- Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW; Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr. 2014 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Resumen
- Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Mercadé Cerdá JM, Sancho Rieger J, Mauri Llerda JA, López González FJ,Salas Puig X. Guías diagnósticas y terapéuticas de la Sociedad Española de Neurología 2012. 1. Guía oficial de práctica clínica en epilepsia. Guías SEN 2012 Texto completo (en nuestros servidores)
- Mintzer S. To test our guess that breast is best: anticonvulsants and breastfeeding. Epilepsy Curr. 2011 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Meador KJ, Baker GA, Browning N, Clayton-Smith J, Combs-Cantrell DT, Cohen M, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW; NEAD Study Group. Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology. 2010 Nov 30;75(22):1954-60. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- O'Connor SE, Zupanc ML. Women and epilepsy. J Pediatr Pharmacol Ther. 2009 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Harden CL, Pennell PB, Koppel BS, Hovinga CA, Gidal B, Meador KJ, Hopp J, Ting TY, Hauser WA, Thurman D, Kaplan PW, Robinson JN, French JA, Wiebe S, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Shafer PO, Le Guen C; American Academy of Neurology; et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of... Neurology. 2009 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Pennell PB. 2005 AES annual course: evidence used to treat women with epilepsy. Epilepsia. 2006 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- O'Brien MD, Gilmour-White SK. Management of epilepsy in women. Postgrad Med J. 2005 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Resumen
- WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Hägg S, Spigset O. Anticonvulsant use during lactation. Drug Saf. 2000 Jun;22(6):425-40. Review. Resumen
- Bar-Oz B, Nulman I, Koren G, Ito S. Anticonvulsants and breast feeding: a critical review. Paediatr Drugs. 2000 Mar-Apr;2(2):113-26. Review. Resumen
- Shimoyama R, Ohkubo T, Sugawara K, Ogasawara T, Ozaki T, Kagiya A, Saito Y. Monitoring of phenytoin in human breast milk, maternal plasma and cord blood plasma by solid-phase extraction and liquid chromatography. J Pharm Biomed Anal. 1998 Resumen
- Meyer FP, Quednow B, Potrafki A, Walther H. [Pharmacokinetics of anticonvulsants in the perinatal period]. Zentralbl Gynakol. 1988 Resumen
- Söderman P, Matheson I. Clonazepam in breast milk. Eur J Pediatr. 1988 Resumen
- Steen B, Rane A, Lönnerholm G, Falk O, Elwin CE, Sjöqvist F. Phenytoin excretion in human breast milk and plasma levels in nursed infants. Ther Drug Monit. 1982 Resumen
- Kaneko S, Sato T, Suzuki K. The levels of anticonvulsants in breast milk. Br J Clin Pharmacol. 1979 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rane A, Garle M, Borgå O, Sjöqvist F. Plasma disappearance of transplacentally transferred diphenylhydantoin in the newborn studied by mass fragmentography. Clin Pharmacol Ther. 1974 Resumen
- Mirkin BL. Diphenylhydantoin: placental transport, fetal localization, neonatal metabolism, and possible teratogenic effects. J Pediatr. 1971 Resumen
- LIVINGSTON S. Treatment of epilepsy with diphenylhydantoin sodium (dilantin sodium). Postgrad Med. 1956 Dec;20(6):584-90. No abstract available. Resumen
- FINCH E, LORBER J. Methaemoglobinaemia in the newborn probably due to phenytoin excreted in human milk. J Obstet Gynaecol Br Emp. 1954 Resumen