Phenytoin sodium is often administered as its sodium salt and has been widely used as an anticonvulsant in the treatment of epilepsy, to a lesser extent and more recently, in the treatment of certain cardiac arrhythmias. The primary site of action appears to be the motor cortex where the spread of the seizure activity is inhibited. Possibly by promoting sodium efflux from neurons, Phenytoin tends to stabilize the threshold against hyper excitability caused by excessive stimulation or environmental changes capable of reducing the membrane sodium gradient. This includes the reduction of posttetanic potentiation at synapses. Loss of posttetanic potentiation prevents cortical seizure foci from detonating adjacent cortical areas. Phenytoin reduces the maximal activity of brain stem centers responsible for the tonic phase of tonic-clonic (grand mal) seizures.
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