A PROSPECTIVE STUDY OF DRUG UTILIZATION PATTERN OF ANTI-EPILEPTIC DRUGS AND THEIR ADVERSE EFFECTS IN A TERTIARY CARE HOSPITAL
Keywords:Drug utilization study (DUS), Anti-Epileptic Drugs (AEDs), Adverse Reactions (AR), Seizure disorder
Objective: Epilepsy or seizure disorder is a common neurologic disorder in the pediatric age group and occurs with a frequency of 4-6 cases per thousand children. Epilepsy, particularly childhood epilepsy, remains a challenge to treat. The management of epilepsy is primarily based on theuse of anti-epileptic drugs. Surgery and diet therapy are the other modes of treating childhood seizures. To get an insight into the utilization pattern of anti-epileptic drugs (AEDs) used in pediatric seizures.
Methods: This prospective, longitudinal study was conducted for a period of 8months in Paediatric Neurology Department of a tertiary care teaching hospital. The data collected from 50 children at the end of the study, were compiled in a specially designed data form and were analyzed.
Results: The distribution of paediatric seizures was found to be high in male children (62%) and in the age group of 2 to 5 y (46%). The majority of the children (70%) were diagnosed with Generalized Tonic-clonic seizures. Sodium valproate was the commonly prescribed AED in all forms of seizures followed by Carbamazepine (18%), Phenobarbitone (4%) and Phenytoin Sodium (4%). AEDs were mostly prescribed as monotherapy (82%). Adverse reactions noted during this study was minimal (12%).Conclusion: Sodium valproate, a conventional AED still remains the commonly prescribed AED for all types of seizures in children aged 2 to 16 y and also was found to be effective and safe.
WHO expert committee the selection of essential drugs. Technical report series 615,WHO,Geneva; 1977.
Pharmacoepidemiology: an introduction. 3rd edition. edited by Hartzena AG, Porta M, Tilson HH. Cincinnati Harvey Whitney books; 1998.
Dukes MNG. Introduction in DUS: Methods and uses: Edited by Dukes MNG, WHO Regional Publications, European series; 1992. p. 1-4.
Capella D. Descriptive tools and analysis in DUS: Methods and uses: Edited by Dukes MNG; 1992. p. 55-78.
Bakassi, Lunde PKM. National drug policies: the need for drug utilization studies. Trends Pharmacol Sci 1986;7:331-4.
Nehru, Kohli K, Kapoor, Sharma. Drug utilization study in outpatient department in Jammu medical college. JK Science 2005;7:149-51.
Hawkey CJ, Hodgson S, Norman A. Effect of reactive pharmacy intervention on quality prescribing. Br Med J 1990;300:986-90.
Ilse truther. A review of drug utilization and methodologies. Jordon J Pharm Sci 2008;1:2.
Lunde PK, Bakaas I. Epidemiology of drug utilization basic concepts and methodology. Acta Med Scand 1988; Suppl 721:7-11.
Strom BL, Stephen EK. Pharmacoepidemiology. 4thed. John Wileyand Sons, England; 2005.
Sjoqvist F, Birkett D. Drug utilization: Introduction to drug utilization research. WHO publications; 2003. p. 76-84.
MNG Dukes. Drug utilization studies. Methods and uses. WHO regional publications. European series; 1993. p. 1-193.
Seizures in childhood/Nelsonâ€™s textbook of pediatrics; 2011. p. 1686-7.
Serradil J, Bjornson DC, Hartzema AG. Drug utilization study methodologies: national and international perspectives. Drug Intell Clin Pharm 1987:21:994-1001.
National Institute for Health Clinical Excellence (NICE) Clinical guidelines 137. The Epilepsies: the diagnosis and management of Epilepsies in adults and children in primary and secondary care; 2012.
CA Naranjo, U Busto, EM Sellers, P Sandor, I Ruiz. Clinical pharmacology and therapeuticsprogram. New England Med J 1981;30:239-45.
Shobana Mathur, Sumana Seu, L Ramesh, Sathish Kumar M. Utilization pattern of antiepileptic drugs and their adverse effects in a teaching hospital. Asian J Pharm Clin Res 2010;3:55-9.
Hasan SS, Bahari MB, Babar ZU. Antiepileptic drug utilization and seizure outcome among Malaysian public hospital Singapore. Med J 2010;51:21-7.
Hansens Y, Deluxe D, Al Belushi. Drug utilization pattern of antiepileptic drugs in Oman. Jelin Pharm Ther 2002:27:357-61.
Aziz H, Akhtar SW, Hasan KZ. Epilepsy in Pakistan and psychosocial problems: A population based epidemiological study. Epilepsia 1997;38:1069.
Mac TL. Epidemiology, etiology, and clinical management of epilepsy in Asia. Lancet Neurol 2001;6:533-43.
Ghai Paul Bagga. Essential paediatrics. Chapter 17. Vol. 7. 2013. p. 529-35.
Shaireen Usman, Dilli Ram Kafle, Krishna Kumar Oli. Clinical profile of patients with Epilepsy. J Nobel Med College 2014;3:1-4.
Chitra Bhajan, Parshava R Mehta, Nissey K Sunny. A study on drug utilization pattern of antiepileptics in pediatrics at a private corporate hospital in Coimbatore, SouthIndia: World J Pharm Pharm Sci 2017;6:542-9.
Jincy George, Julia Jose, Divya Ashok Kulkarni, Ramesh Rajesh Poi. Evaluation of drug utilization and analysis of AEDs at tertiary care hospital. Indian J Pharm Practice 2016;9:189-94 .
Loscher. Basic pharmacology of valproateâ€“a review after 35 y of clinical uses for the treatment of epilepsy. CNS Drugs 2002;16:669-74.
Glauser TA, Buchhalter JR. Management of childhood epilepsy. Continuum (Minneap Minn) 2013:19;656-81.
Krithika M Bhatt, Supriya D Malhotra, Kamlesh P Patel. Drug utilization in pediatric neurology outpatient department in India. J Basic Clin Pharmacol 2014;5:68-73.
Mansur Habib, Sharif Uddin Khan, Mohd Azhakul Hoque. Anti-epileptic drug utilization in Dhaka Medical College Hospital, Bangladesh. Asian J Pharm 2010;6:575-8.
Maity N, Gangadhar N. Trends intheutilization of AEDs, among pediatricpatientsin a tertiary care hospital. Curr Neurobiol 2011;2:117-23.