Extended use of which antiseizure medication can induce facial coarsening, hirsutism, gingival hyperplasia, and osteomalacia?
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Answer: D. Phenytoin
Explanation
Chronic phenytoin therapy is well known for causing distinct and characteristic adverse effects. Prolonged exposure leads to gingival overgrowth, facial coarsening, hair growth, and bone softening. Option D is correct because these specific side effects are classic hallmarks of phenytoin toxicity. Phenytoin is a traditional antiepileptic drug used to manage generalized and partial seizures. It exhibits complex pharmacokinetics with nonlinear elimination kinetics at higher therapeutic doses. Long-term use impacts collagen metabolism, calcium homeostasis, and endocrine function significantly.
Patients taking phenytoin long-term require meticulous oral hygiene to manage severe gingival hyperplasia. Regular bone density screenings help detect osteomalacia and prevent fractures in chronic users. Clinicians monitor drug levels closely to minimize adverse cosmetic and systemic complications. Valproic acid is associated with weight gain, tremor, and hepatotoxicity rather than gingival hyperplasia. Carbamazepine frequently causes hyponatremia and blood dyscrasias instead of characteristic facial coarsening. Ethosuximide is primarily used for absence seizures and typically causes gastrointestinal distress.
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