@Ruthless Logic,
For god's sake, here is the FDA-approved package insert and full prescribing information for phenytoin. Take a brief look at "indications and usage":
http://media.pfizer.com/files/products/uspi_dilantin.pdf
Being one of the oldest drugs still in use (first marketed around 1960), phenytoin
has been tried for a lot of things, both off-label and in clinical trials. But we're talking about a generation ago. Phenytoin is a notoriously toxic drug that has a very limited set of uses these days.
Ruthless Logic wrote:Distal Phalanges.....word salad? The disease process of osteoarthritis can effect the Distal Phalanges of some individuals, and the anti-inflammatory attributes of the drug Phenytoin can relieve the symptoms of osteoarthritis in some patients. You should spend less time being critical of me as it pertains to the therapeutic value of a prescribed drug, and more time paying down your student loan from the University of Phoenix.
Distal phalanges is only word salad when used in the sentence "
Phenytoin is used to treat most types of distal phalanges", which is what you wrote. A phalanx (the singular of phalanges) is an anatomic word and "distal" refers to the end farther away from the body (it's the opposite of "proximal").
So what you wrote is like writing "Tylenol is used to treat most types of heads."
Yes, osteoarthritis affects the interphalangeal
joints (arthritis refers to joints, not
bones which the phalanges are). However, antiinflammatories in clinical trials are marginally effective for osteoarthritis, with little difference between antiinflammatories (like ibuprofen) and non-antiinflammatory analgesics (like acetominphen).
Phenytoin is
not an effective antiinflammatory, it is not used therapeutically for osteoarthritis, and in fact it is known to
worsen osteoarthritis in rare cases (Eur J Intern Med. 2001 Sep;12(5):448-450). It has been studied for
rheumatoid arthritis which is a completely different disease than
osteoarthritis, and it has had some efficacy in those few studies, but it is not in clinical use because there are numerous better, safer drugs for RA. It's a very toxic drug that has limited use, almost exclusively for acute and chronic seizure management (it's probably used off-label for some refractory psychiatric disorders and severe neuropathic pain disorders as well, but that's not my specialty so I'm not sure). Phenytoin has a LOT of toxicities, including drug interactions, hepatotoxicity, and drug rashes, so its use is pretty limited.
As for my medical training, Harvard Medical School and the University of Connecticut School of Medicine have been kind enough to be my homes for the last 11 years of my medical career, and I've just taken a faculty position as one of the core teachers in the internal medicine and med-peds residencies at Duke Medical School. I hold three board certifications, two licenses, DEA certification, and a number of publications and awards. But hey, you were close.
Why are we fighting about this, by the way? Oh, because you called it a cardiac drug and I said that it wasn't. Can we just get back to the topic now?