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Since no action potential arrives to the nerve terminal, calcium entry does not occur and neurotransmitters like glutamate are not released from synaptic vesicles into the synapse. Phenytoin blocks the channel, preventing the entry of sodium into the neuron. Glutamate receptor 1 Glutamate receptor 2 Glutamate [NMDA] receptor subunit epsilon-1 Glutamate [NMDA] receptor subunit zeta-1 Glutamate [NMDA] receptor subunit epsilon-3 Glutamate [NMDA] receptor subunit epsilon-2 Glutamate [NMDA] receptor subunit epsilon-4 Glutamate [NMDA] receptor subunit 3A Glutamate [NMDA] receptor subunit 3B Sodium channel protein type 5 subunit alpha Potassium voltage-gated channel subfamily D member 2 Kv channel- interacting protein 2 Voltage- dependent P/Q-type calcium channel subunit alpha-1A Voltage- dependent L-type calcium channel subunit beta-1 Voltage- dependent calcium channel subunit alpha-2/delta-2 Voltage- dependent T-type calcium channel subunit alpha-1H Voltage- dependent T-type calcium channel subunit alpha-1G Multidrug resistance- associated protein 4 Solute carrier family 22 member 11 Alkaline phosphatase, tissue- nonspecific isozyme Cytochrome P450 2C9 Glutamate Phenytoin K+ K+ Ca+ Ca+ Glutamate Na+ Na+ Ca+ Ca+ Ca+ Ca+ Na+ Na+ Phenytoin Fosphenytoin 3-(Hydroxymethyl)phenytoin Phenytoin Heme Depolarization axon width = 9 Presynaptic Neuron Post-synaptic Neuron Membrane Potential (mV) 0 40 -70 Hyperpolarization Repolarization Peak action potential Resting potential The depolarization phase of the action potential is inhibited, therefore, the action potential cannot be geenrated. ACTION POTENTIAL Time (ms) Endoplasmic Reticulum Hepatocyte The post-synaptic neuron is unable to depolarize due to the inhibition of neurotransmitter release. Synaptic Vesicle Fosphenytoin is administered via intravenous or intramuscular injection
Mitochondria Endoplasmic Reticulum GRIA1 GRIA2 GRIN2A GRIN1 GRIN2C GRIN2B GRIN2D GRIN3A GRIN3B SCN5A KCND2 KCNIP2 CACNA1A CACNB1 CACNA2D2 CACNA1H CACNA1G ABCC4 SLC22A11 ALPL CYP2C9 Glutamate Phenytoin Potassium Potassium Calcium Calcium Glutamate Sodium Sodium Calcium Calcium Calcium Calcium Sodium Sodium Phenytoin Fosphenytoin 3- (Hydroxymethyl)phenytoin Phenytoin