Daily Doodle #111 – Pictoffect: Phenytoin

I’ve been deliberating over ways to study for my pharmacy licensing exams and continue my daily doodle without feeling guilty that it’d eat into potential study hours.

Sooo….over this final month leading up to my exam, I’m going to sketch creatures that represent drugs & their side effects.
I call ’em “Pictoffects”.

I’ll illustrate drugs which have strange side effect profiles, which I have a particularly difficult time memorizing.
Chances are if I’m getting frustrated with these, there are several other pharmacy students out there sailing in the same boat.
My hope is that presenting these side effects in a stimulating, visual way will increase retention!

I’m going to try my best to keep the illustrative style consistent…kind of reminiscent of a kiddy storybook from the 70’s.
Maybe not a bad way to kill two birds, although I can already sense that the resultant creatures are going to be truly pitiful, ugly little things…

Anyway, without further ado, meet my first Pictoffect
Mr. Phenytoin


Featuring the following
Side Effects:
Somnolence (moon)
Lupus-like symptoms
Vitamin D deficiency
Gingival Hyperplasia

Other Side Effects (not depicted)
GI (N&V, diarrhea)
↓ coordination & concentration
Blood dyscrasias
Folic acid ↓
T4 ↓

Other Tedious Tidbits about Phenytoin
Suspension/tablets are 100% bioavailable, while the capsules & injections are only 92%
Phenytoin exhibits saturable kinetics, so increasing dose will dramatically spike blood levels.
CBC, LFT and plasma folate levels should be monitored while taking phenytoin.
Serum troughs should be at 40-80 umol/L at steady state.

Reference: Rx Files 9th Edition