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左乙拉西坦在妊娠癫痫患者中的剂量调整策略:病例报告及文献复习。

Dose adjustment strategy of levetiracetam in pregnant patients with epilepsy: Case report and literature review.

机构信息

Department of Clinical Pharmacy, Xiangtan Central Hospital, Xiangtan, China.

Department of Children Health Care, The Maternity And Children Health Hospital of Xiangtan City, Xiangtan, China.

出版信息

Medicine (Baltimore). 2024 Apr 26;103(17):e37977. doi: 10.1097/MD.0000000000037977.

Abstract

RATIONALE

Pregnant patients with epilepsy are prone to preterm delivery, stillbirth, or cesarean section, and their mortality rate is almost 10 times higher than that of normal pregnant women. The potential negative influences of antiepileptic drugs (AEDs) on the fetus are weighed against the necessity for achieving optimal control of seizures. Treatment with AEDs during pregnancy is a major challenge for pregnant women and healthcare teams.

PATIENT CONCERNS

This paper reports two cases of young women diagnosed with pregnancy and epilepsy.

INTERVENTION

The dose of levetiracetam was adjusted under the guidance of therapeutic drug monitoring to reduce the effects of seizures on the fetus and the incidence of reproductive toxicity caused by adverse drug reactions.

OUTCOMES

Epilepsy was well controlled in the two pregnant patients, and the newborns had no genetic disorders.

LESSONS

It is recommended to regularly monitor the serum LEV level in pregnant patients with epilepsy. This practice serves as a foundation for adjusting the drug treatment plan and offering more precise guidance for medication management during pregnancy.

摘要

背景

患有癫痫的孕妇容易早产、死产或剖宫产,其死亡率几乎是正常孕妇的 10 倍。抗癫痫药物(AEDs)对胎儿的潜在负面影响与控制癫痫发作的必要性相权衡。在怀孕期间使用 AEDs 是孕妇和医疗团队面临的主要挑战。

病例报告

本文报道了两名年轻女性被诊断为妊娠合并癫痫的病例。

干预措施

在治疗药物监测的指导下调整左乙拉西坦的剂量,以减少癫痫对胎儿的影响以及不良反应引起的生殖毒性的发生率。

结果

两名孕妇的癫痫均得到良好控制,新生儿无遗传疾病。

结论

建议定期监测癫痫孕妇的血清 LEV 水平。这一实践为调整药物治疗计划提供了基础,并为孕期用药管理提供了更精确的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068d/11049779/d56339b12415/medi-103-e37977-g001.jpg

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