Which of the following is a side effect of Phenytoin:

Appeared in: BHU NO-2019

Explanation

Gum hypertrophy (gingival hyperplasia) is the most common side effect of phenytoin, occurring in about 20% of patients, especially younger ones.
It results from the overgrowth of collagen fibers in the gingival tissue.
This side effect can be managed and minimized with meticulous oral hygiene, including regular brushing and dental check-ups.

Option B: Phenytoin is associated with hirsutism (excessive hair growth), not alopecia (hair loss).
Option C: Phenytoin can inhibit insulin release, which may lead to hyperglycemia (high blood sugar), not hypoglycemia.
Option D: Gynaecomastia is not a recognized side effect of phenytoin.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Adverse effects of Phenytoin as background academic context rather than a clinical decision trigger.
Nurses must educate patients on phenytoin about the critical importance of oral hygiene to prevent or minimize gum hypertrophy. This includes teaching proper brushing techniques and advising regular dental visits.
Monitoring for phenytoin toxicity is a key nursing responsibility due to its narrow therapeutic index (10-20 mcg/mL). Early signs of toxicity include nystagmus, ataxia, and slurred speech.
Patient teaching should also cover other potential side effects like hirsutism and the need to report any skin rashes immediately, as they could signify a severe hypersensitivity reaction.

How to Approach the Question

First, identify the core of the question, which is asking for a known side effect of the drug Phenytoin.
Recall or look up the pharmacological profile of Phenytoin, focusing on its common and significant adverse effects.
Evaluate each option against this knowledge.
Option A, Gum hypertrophy, is a classic, well-known side effect of phenytoin.
Option B, Alopecia, is incorrect; phenytoin causes hirsutism.
Option C, Hypoglycemia, is incorrect; phenytoin can cause hyperglycemia.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 78-80

E6 Pharmacology Nursing Lilley 11e Part 1 p. 241-243

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1419-1421

Practise the full BHU NO-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.