Side effects of phenytoin are all EXCEPT
High-Yield Explanation
(C) Microcytic anemia # 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), aerie.> 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.