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Dilantin overdose

Dilantin is a medicine used to prevent seizures. Overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient


  • Phenytoin

Where Found


  • Dilantin
  • Phenytoin

Symptoms

The symptoms vary, but may include:

Home Care

Seek immediate medical help. Do NOT make a person throw up unless told to do so by poison control or a health care professional.

Before Calling Emergency

Determine the following information:

  • Patient's age, weight, and condition (for example, is the person awake or alert?)
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed
  • If the medicine was prescribed for the patient

However, do NOT delay calling for help if this information is not immediately available.

Poison Control

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:

  • Activated charcoal
  • Breathing support, including a┬átube through the mouth and breathing machine (ventilator)
  • EKG (heart tracing)
  • Fluids through a vein (by IV)
  • Medications to reverse the effects of the drug
  • Tube through the mouth into the stomach to wash out the stomach (gastric lavage )

Outlook (Prognosis)

The outlook depends on the severity of the overdose:

  • Mild overdose: Supportive therapy alone may be all that is needed. Recovery is likely.
  • Moderate overdose: With proper treatment, the patient usually makes a complete recovery within 24 to 48 hours.
  • Severe overdose: If the patient is unconscious or vital signs are abnormal, more aggressive treatments may be necessary. It may take 3 to 5 days before the patient wakes up (becomes conscious). Complications such as pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. However, unless there are complications, long-term effects and deaths are uncommon. Death usually occurs as a result of liver failure.

References

Osborn H. Phenytoin and fosphenytoin toxicity. In: Tintinalli J, et al. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 178.

McMullan JT, Duvivier EH, Pollack Jr. CV. Seizures. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 102.

Updated: 1/18/2014

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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