College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Medicine (Baltimore). 2021 Jul 2;100(26):e26478. doi: 10.1097/MD.0000000000026478.
This study aims to evaluate the effect of dose titration for different oral antiepileptic medications among children with epilepsy in Riyadh, Saudi Arabia.A single-center prospective pilot, cohort study was undertaken at a tertiary hospital in Riyadh, Saudi Arabia. All medical records of pediatric patients below the age of 14 years of age who has been newly diagnosed with epilepsy by attending a medical specialist or on a new epileptic treatment plans were enrolled in the study.A total of 76 epileptic patients were screened for 3 months' period and 48 patients were included in this study. Out of the 48 patients, 31 patients followed the regular practice in the titration processes and 17 patients were in the British national formulary (BNF) guideline. Fifteen children who were on monotherapy of levetiracetam were in regular practice guideline experienced poor seizure control with a recorded number of seizure incidence (n = 10). The patient in regular practice guidelines using a combination therapy of phenytoin and levetiracetam were experiencing some behavioral disturbance and sedation effect. Seventeen patients followed in the BNF guideline who were on levetiracetam were experienced less adverse effect (n = 2) with no behavioral changes.The group who followed the regular practice found having a greater incidence of documented adverse effects compared to the patients following the BNF guideline. The titrating antiepileptic medication has a detrimental effect on the pediatric population as observed in this study.
本研究旨在评估在沙特阿拉伯利雅得,针对不同的口服抗癫痫药物对癫痫儿童进行剂量滴定的效果。
在沙特阿拉伯利雅得的一家三级医院进行了一项单中心前瞻性试点、队列研究。所有年龄在 14 岁以下、经主治医生诊断或新制定癫痫治疗计划的儿科患者的病历均纳入本研究。在 3 个月的时间里,共有 76 名癫痫患者接受了筛查,其中 48 名患者纳入了本研究。在这 48 名患者中,有 31 名患者遵循常规剂量滴定过程,有 17 名患者遵循英国国家处方集(BNF)指南。在常规实践指南中,15 名接受左乙拉西坦单药治疗的儿童癫痫控制不佳,记录的癫痫发作次数(n=10)。在常规实践指南中使用苯妥英和左乙拉西坦联合治疗的患者出现一些行为障碍和镇静作用。在 BNF 指南中,17 名接受左乙拉西坦治疗的患者不良反应较少(n=2),且无行为改变。与遵循 BNF 指南的患者相比,遵循常规实践指南的患者出现不良事件的记录发生率更高。本研究观察到,调整抗癫痫药物对儿科人群有不良影响。