The mechanism of action of hydantoins is not yet conclusive. According to one hypothesis, hydantoins prevent high-frequency activation of the epileptogenic center and also facilitate secretion of sodium ions, which reduces excitation of neurons and prevents their activation upon contact with impulses from the epileptogenic center.
Phenytoin: Phenytoin, 5,5-diphenylimidazolidinedione (9.1.1) is synthesized in two different ways. The first involves a rearrangement on the reaction of benzil with urea to form the desired product (9.1.1) .
The second method involves the reaction of benzophenone with sodium cyanide in the presence of ammonium carbonate, followed by the simultaneous cyclization of the resulting product (carboxyaminonitrile) and its rearrangement under the reaction conditions to form phenytoin .
In terms of its effect on the CNS, phenytoin is considered an excellent antiepileptic drug with insignificant sedative effects. Even in large doses it does not cause hypnosis. It is presumed that phenytoin facilitates secretion of sodium ions from nerve cells, which reduces the stimulation of neurons. This in turn prevents the activation of neurons upon receiving impulses from the epileptogenic center. In addition, phenytoin reduces the incoming flow of potassium ions during repolarization. It is possible that phenytoin significantly slows the distribution of excitation in the brain as a direct result of the redistribution of the ion flow.
Phenytoin is used primarily in the treatment of major epileptic attacks. Difhydan, alepsin, dilantin, and solantin are the primary synonyms for phenytoin.
Ethotoin: Ethotoin, 3-ethyl-5-phenylimidazolidine-2,4-dione (9.1.5), is synthesized in basically the same manner as described above, which in this case involves the reaction of benzaldehyde oxynitrile (9.1.2), with urea or ammonium hydrocarbonate, which forms the intermediate urea derivative (9.1.3) which on acidic conditions (9.1.3) cyclizes to 5-phenylhydantoin (9.1.4). Alkylation of this product using ethyliodide leads to the formation of ethotoin (9.1.5) [3,4].
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Hypnosis is a capital instrument for relaxation and alleviating stress. It helps calm down both the brain and body, giving a useful rest. All the same it can be rather costly to hire a clinical hypnotherapist, and we might not always want one around when we would like to destress.