Does phenytoin increase blood glucose levels?
It appears that an elevated blood sugar response is a known side effect of toxic levels of phenytoin (Dilantin).
What increases serum glucose concentration?
The Role of Glucagon. Glucagon, a peptide hormone secreted by the pancreas, raises blood glucose levels. Its effect is opposite to insulin, which lowers blood glucose levels. When it reaches the liver, glucagon stimulates glycolysis, the breakdown of glycogen, and the export of glucose into the circulation.
Does phenytoin cause hypoglycemia?
Beside the well known hyperglycaemic effect of phenytoin, it has been reported that high doses of the drug can induce hypoglycaemia. In particular, a recent study reported a case of hypoglycaemia secondary to an acute voluntary intoxication with 20 g of phenytoin.
What is serum glucose concentration?
Glucose is the carbohydrate normally found in mammalian blood and is referred to as the “blood sugar.” With few exceptions, it is equally distributed in the water of the extracellular fluids; as a result of the lower water content of the red blood cells, serum or plasma glucose values average 10% to 15% greater than …
How does phenytoin cause diabetes?
Phenytoin is known to induce hyperglycaemia. The mechanism has generally been considered primarily an inhibition of insulin release. We have recently treated a patient who became hyperglycaemic on phenytoin and whose markedly increased insulin requirements suggested an insulin resistant state.
What hormone increases blood sugar?
Changes in your blood sugar levels can affect how you feel. To help you keep the level steady and healthy, your body makes a hormone called glucagon while you sleep and after you eat. It’s made in your pancreas, a small organ above your liver, and it can raise levels of glucose, or sugar, in your blood.
What two factors affect glucose concentration?
Factors include food and physical activity choices, some medications, and skipping or not taking enough glucose-lowering medication. In addition, illness, injury, surgery, stress, menstruation and menopause can influence blood sugar levels.
Can anticonvulsants cause hypoglycemia?
also reported that some antiepileptic drugs (gabapentin, phentoin, topiramate) caused iatrogenic hypoglycemia [9]. It was hypothesized that the underlying mechanisms were insulin release or the reduction of its clearance, and/or an interference in the glucose metabolism [9].
Why is serum glucose important?
It’s important to keep your blood sugar levels in your target range as much as possible to help prevent or delay long-term, serious health problems, such as heart disease, vision loss, and kidney disease.
What is the difference between blood glucose and serum glucose?
Whole blood and serum blood glucose is often different. Red blood cells have higher concentration of protein than serum and serum has higher water content and more dissolved glucose than whole blood. To obtain blood glucose in serum from figures in whole blood, it is multiplied by 1.15.
Does phenytoin affect blood clotting?
Phenytoin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting.
What is the therapeutic range of phenytoin?
Phenytoin has a narrow therapeutic window, between 10-20 mg/L. Serum concentrations of phenytoin are monitored by measuring the total phenytoin concentration. However, phenytoin is generally 90% bound to plasma proteins (mostly albumin), and only its unbound form is pharmacologically active.
What is the relationship between albumin and phenytoin levels?
Phenytoin is highly protein bound and where protein binding is reduced, as in uraemia and hypoalbuminaemia, free phenytoin concentration levels will be increased accordingly. Therefore a patient with low albumin (<35g/L) may have a therapeutic level of free phenytoin but an overall low phenytoin level.
What is the molecular formula for phenytoin?
Phenytoin PubChem CID 1775 Structure Find Similar Structures Chemical Safety Laboratory Chemical Safety Summary (LCSS Molecular Formula C15H12N2O2 Synonyms phenytoin 5,5-DIPHENYLHYDANTOIN 57-41-0
How is phenytoin metabolized in the body?
The drug is widely distributed in the body and is almost completely protein-bound, primarily to albumin. Phenytoin is metabolized primarily in the liver by CYP2C9 and CYP2C19 to 5- (4-hydroxyphenyl)-5-phenylhydantoin, which is glucuronidated and excreted.