Gingival hypertrophy and hirsutism are the side effects of following Antiepileptic drug use

(D) Diphenylhydantoin # Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.# Adverse effects These are numerous; some occur at therapeutic plasma concentration after prolonged use, while others are manifestation or toxicity due to overdose.# At therapeutic levels> Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.> Hypersensitivity reactions are--rashes, DLE, lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.> Megaloblastic anaemia: phenytoin decreases folate absorption and increases its excretion.> Osteomalacia: phenytoin desensitizes target tissues to vitamin D and interferes with calcium metabolism.> It can inhibit insulin release and cause hyperglycaemia.> Used during pregnancy--can produce foetal hydantoin syndrome (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.