Phenytoin Sodium and Sertraline Hydrochloride

• Generic Name: phenytoin
• Dosage Forms: injection, solution
• Other Brand Names: Dilantin, Dilantin Infatabs, Phenytek, Phenytoin Sodium, Prompt

Management of generalized tonic-clonic (grand mal) seizures.

Management of partial seizures with complex symptomatology (psychomotor and temporal lobe seizures).

Not recommended for treatment of pure absence (petit mal) seizures since the drug may increase frequency of these seizures, but may be used in conjunction with other anticonvulsants when mixed seizure types are present.

Prevention and treatment of seizures occurring during and following neurosurgery.

Used IV for treatment of status epilepticus; however, use may be limited by its slow onset of action and need for slow administration.

Benzodiazepines (e.g., diazepam, lorazepam, midazolam) are considered drugs of choice for initial treatment of status epilepticus; IV phenytoin (or fosphenytoin) may be used as a second-line agent if seizures continue.

Concurrent administration with an IV benzodiazepine or short-acting barbiturate will usually be necessary for rapid control of seizures.

Fosphenytoin appears to be better tolerated than phenytoin, and some experts state that fosphenytoin is preferred when both drugs are available.

Has been used IV for treatment of cardiac arrhythmias, particularly ventricular arrhythmias, in patients who do not respond to conventional antiarrhythmic agents or cardioversion. However, current use as an antiarrhythmic agent is limited by the drug's narrow therapeutic window, multiple drug interactions, and adverse effect profile.

Has been used IV for treatment of arrhythmias caused by cardiac glycoside intoxication, especially in the presence of AV block, because the drug improves conduction through the AV node.

• Generic Name: sertraline
• Dosage Forms: n.a.
• Other Brand Names: Zoloft

Management of major depressive disorder.

Efficacy in hospital settings not established.

APA states that effectiveness of antidepressants is generally comparable between and within classes of medications, including SSRIs, SNRIs, TCAs, MAOIs, and other antidepressants (e.g., bupropion, mirtazapine, trazodone). Choose antidepressant based mainly on patient preference; nature of prior response to medication; safety, tolerability, and anticipated adverse effects; concurrent psychiatric and medical conditions; and specific properties of the medication (e.g., half-life, actions on CYP450 enzymes, other drug interactions). For most patients, an SSRI, SNRI, mirtazapine, or bupropion is considered optimal. Consult APA’s Practice Guidelines for the Treatment of Patients with Major Depressive Disorder for additional information.

Management of OCD; reduces but does not completely eliminate obsessions and compulsions.

Management of panic disorder with or without agoraphobia.

Management of PTSD; more effective in women than in men.

Not effective for combat- or war-related PTSD.

Management of PMDD; improves symptoms (e.g., depressed mood, premenstrual anger/irritability) and functional impairment (e.g., difficulty in concentrating, lethargy) associated with this disorder.

Efficacy when used in conjunction with oral contraceptives for the treatment of PMDD is unknown.

Management of social phobia (social anxiety disorder).

Has been used in the management of premature ejaculation.

Has been used in the management of vascular headaches with equivocal efficacy.