Dilantin overdose

Poisonous Ingredient

• Phenytoin

Where Found

• Dilantin
• Phenytoin

Symptoms

The symptoms vary, but may include:

• Coma
• Confusion
• Fever
• Involuntary, jerky, repeated movement of the eyeballs (nystagmus)
• Lethargy
• Low blood pressure
• Nausea
• Sleepiness
• Slow or slurred speech
• Staggering gait or walk
• Swollen gums
• Tremor
• Unsteadiness
• Uncoordinated movements
• Vomiting

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 tube
• Fluids through a vein (by IV)
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
• Oxygen

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). 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.

Update Date: 2/6/2012

Reviewed by: Eric Perez, MD, St. Luke's / Roosevelt Hospital Center, NY, NY, and Pegasus Emergency Group (Meadowlands and Hunterdon Medical Centers), NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.