Dwajani S, Adarsh E, Nirmala K S, Sahajananda H
Department of Pharmacology and Central Research laboratory, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India.
Department of Pediatrics, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India.
J Neurosci Rural Pract. 2019 Jul;10(3):474-478. doi: 10.1055/s-0039-1698280. Epub 2019 Oct 9.
Drug utilization studies are important and considered as a potential tool for the evaluation of health care systems. The goal of drug utilization research studies should be to assess whether drug therapy is rational or not. The main aim of this article is to analyze the different types of epilepsy and their drug utilization pattern in children with epilepsy at the Department of Pediatrics and evaluate the extent of older and newer antiepileptic drugs (AEDs), either as monotherapy or polytherapy in pediatric age groups. To look into the sociodemographic profile of children with epilepsy, the type of epilepsy was diagnosed along with drug utilization pattern in children attending both outpatient and inpatient department of pediatrics. Demographic details were collected according to modified Kuppuswamy scale. Disease characteristics such as type of epilepsy, onset, duration, time since last attack, family history, comorbid conditions, monotherapy/polytherapy, dose, and duration of treatment were noted. Investigations such as electroencephalography, magnetic resonance imaging, and computed tomographic scan if any were recorded. In this pilot study, we have 100 patients, younger than 18 years, with confirmed cases of epilepsy, receiving AEDs either monotherapy or polytherapy. Male predominance was 56%, and 60% were from rural areas and 40% were from urban areas. As per the modified Kuppuswamy scale, we analyzed socioeconomic class of these 100 patients and found that 40% belong to lower-middle-class family. Nearly 51% were diagnosed with generalized tonic clonic seizures, 30% were with febrile seizures, while focal, partial, absence, and myoclonic seizures, and hot water epilepsy were less in percentage. Almost 83% received monotherapy, while only 17% received polytherapy. Among monotherapy, 51.80% received older AEDs and 48.20% received newer drugs. Although epilepsy can be controlled and managed effectively with older AEDs, an experience in management with newer AEDs is required to offer an additional advantage to patients to have better safety profile.
药物利用研究很重要，被视为评估医疗保健系统的一种潜在工具。药物利用研究的目标应该是评估药物治疗是否合理。
本文的主要目的是分析不同类型的癫痫及其在儿科癫痫患儿中的药物利用模式，并评估老年和新型抗癫痫药物（AEDs）在儿科年龄组中作为单一疗法或联合疗法的使用程度。
为了了解癫痫患儿的社会人口统计学特征，对在儿科门诊和住院部就诊的儿童进行癫痫类型诊断以及药物利用模式调查。根据修改后的库普苏瓦米量表收集人口统计学细节。记录疾病特征，如癫痫类型、发作、持续时间、上次发作时间、家族史、合并症、单一疗法/联合疗法、剂量和治疗持续时间。记录脑电图、磁共振成像和计算机断层扫描等检查（如有）。
在这项试点研究中，我们有100名18岁以下确诊为癫痫的患者，接受单一疗法或联合疗法的抗癫痫药物治疗。男性占比56%，60%来自农村地区，40%来自城市地区。根据修改后的库普苏瓦米量表，我们分析了这100名患者的社会经济阶层，发现40%属于中低收入家庭。近51%被诊断为全身强直阵挛发作，30%为热性惊厥，而局灶性、部分性、失神性、肌阵挛性发作以及热水癫痫的比例较低。几乎83%接受单一疗法，而只有17%接受联合疗法。在单一疗法中，51.80%使用老年抗癫痫药物，48.20%使用新型药物。
虽然使用老年抗癫痫药物可以有效控制和管理癫痫，但需要有使用新型抗癫痫药物的管理经验，以便为患者提供额外优势，使其具有更好的安全性。
