Hydantoins 乙内酰脲类药
Hydantoins include ethotoin (Peganone), fosphenytoin (Cerebyx), and phenytoin (Dilantin). Because hydantoins are generally less sedating than many other antiepileptics, they may be the drugs of choice for patients who are not willing to tolerate sedation and drowsiness. They do have significant adverse effects; thus, less toxic drugs, such as benzodiazepines, have replaced them in many situations.
乙内酰脲类药包括ethotoin 乙（苯）妥英 (Peganone皮加隆 ), fosphenytoin 磷苯妥英 (Cerebyx 【奥】塞洛比克), and phenytoin 苯妥英(Dilantin 锹兰汀)。因为乙酰脲类药的镇静作用一般比其他很多药物要低，这些药物可能是不乐意耐受镇静和瞌睡的患者的首选药物。这些药物没有重大的不良效应，因此，在很多情况下，已经被毒性较小的药物所替代，如苯二氮卓类药。 Safe Medication Administration 安全用药
Be aware that name confusion has been reported among Cerebyx (fosphenytoin), Celebrex (celecoxib; a nonsteroidal anti-inflammatory agent), Celexa (citalopram, a selective serotonin reuptake inhibitor antidepressant), and Xanax (alprazolam, an antianxiety drug). Because these drugs have sound-alike, look-alike names, if your patient is prescribed any of these drugs, make sure you know what the drug is being used for and that the patient is getting the correct prescribed drug.
注意，现有报告表明，【奥】西乐比克（磷苯妥英）、西乐葆（塞来昔布，非类固醇抗炎药）、喜普妙（西酞普兰，选择性5羟色胺再吸收抑制剂）、安宁神（阿普唑仑，抗焦虑药）等出现药名混乱。由于这些药物名称发音、词形相似，你给患者处方这些药物时，都应确保你知识自己的用药目的，患者使用正确的处方药物。 Drug–Drug Interactions
临床重要的药-药相互作用
Because the risk of CNS depression is increased with hydantoins taken with alcohol, patients should be advised not to drink alcohol while they are taking these agents. Always consult a drug reference before any drug is added to or withdrawn from a therapeutic regimen that involves any of these agents.
鉴于乙内酰脲类与乙醇一起使用时CNS抑制风险增加，应建议患者服药期间不要饮酒。当涉及添加任何药物或中止涉及这些药物的治疗方案前，必须始终咨询药物的参考说明。 Herbal and Alternative Therapies
草药与替代疗法
Patients being treated for epilepsy should be advised not to use the herb evening primrose because it increases the risk of having seizures. Patients being treated with barbiturates or phenytoin should be advised not to use ginkgo, which could cause serious adverse effects.
应建议接受癫痫治疗的患者不要使用月见草，因为该草药增加癫痫得病风险。应建议使用巴比妥酸盐类或苯妥英治疗的患者不要使用银杏，该药可能引起严重的不良效应。
★Vocabulary for Today ★
hydantoins – n. 乙内酰脲类药
ethotoin – n. 乙（苯）妥英 Peganone – n. 皮加隆
fosphenytoin – n. 磷苯妥英 Cerebyx – n. 【奥】塞洛比克
phenytoin – n. 苯妥英 Dilantin – n. 锹兰汀
antiepileptics – n. 抗癫痫药
benzodiazepines – n. 苯二氮卓类药
name confusion – 药名混乱
Celebrex – n. 西乐葆
celecoxib – n. 塞来昔布
Celexa – n. 喜普妙
citalopram – n. 西酞普兰
Xanax – n. 安宁神
alprazolam – n. 阿普唑仑
evening primrose – n. 月见草
ginkgo – n. 银杏
1. Mr. Jessie Ray, a newly admitted patient, has a seizure disorder which is being treated with medication. Which of the following drugs would the nurse question if ordered for him?
A. Phenobarbitol, 150 mg hs
B. Amitriptylene (Elavil), 10 mg QID.
C. Valproic acid (Depakote), 150 mg BID
D. Phenytoin (Dilantin), 100 mg TID 2. A 17-year-old client is taking Phenytoin (Dilantin) for the treatment of seizures. Phenytoin blood level reveals to be 25 mcg/ml. Which of the following symptoms would be expected as a result of the laboratory result?
A. No symptoms, because the value is within the normal range.
B. Hypoglycemia.
C. Tachycardia.
D. Nystagmus.
Answers 答案 1. B. Amitriptylene (Elavil), 10 mg QID. Rationale: Elavil is an antidepressant that lowers the seizure threshold, so would not be appropriate for this patient. The other medications are anti-seizure drugs. 2. D. Nystagmus. Rationale: The therapeutic level of phenytoin is 10-20 mcg/ml. Higher than 20 mcg/ml results in nystagmus (Involuntary eye movement).
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