Dr. Sengottuvel Viswanathan Delhi University Delhi.

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Presentation transcript:

Dr. Sengottuvel Viswanathan Delhi University Delhi

 Epilepsy- recurrent seizures due to chronic underlying process  Incidence is 5 to 7 per 10,000 children.  5 among 1,000 children have epilepsy.  Various etiologies.

 Generalized seizures Tonic clonic, absence, clonic, tonic, atonic,myoclonic.  Focal seizures.  Unknown : epileptic spasms.  Clinical diagnosis is supported by neuro- imaging and electro physiological studies.  Management: Anti epileptic drugs ( AEDs)

 Definition  WHO in 1977 defined drug utilization as marketing, distribution, prescription and use of drugs in a society with special emphasis on the resulting medical, social and economic consequences.  Types  Cross sectional  Longitudinal  Continuous longitudinal.

 To study the drug utilization pattern of anti-epileptic drugs in pediatric population.  Objectives:  Prescribing pattern  Seizure control and adverse effects  Cost of therapy and financial burden.

 Hospital based descriptive study  200 pediatric patients on AEDs  Data collected in suitably designed from  Inclusion criteria : 3 months to 12 years diagnosed with epilepsy and receiving oral AEDs.  Exclusion criteria : patients unwilling to participate.

 Age, sex, weight, duration of treatment, diagnosis were noted.  Prescribing pattern of AEDs was assessed according to WHO indicators.  Patients followed up at 3 months for seizure control and adverse drug reactions.  ADRs were documented and reported.

 Demographic profile (n=200)  Boys - 59% ( n=118)  Girls - 41% (n= 82)  Mean age = 7.14 yrs.

Type of seizure  GTCS 61.5% (N=123)  Complex partial 30% (N= 60)  Simple partial 5% (N=10)  Myoclonic 3% (N=6)  Absence 0.5% (N=1)

Total (N=200)

Type of seizure Seizure control with Monotherapy (n=175) Seizure control with Combination therapy (n=25) GoodPoorGoodPoor GTCS M=105 C = %(n=94)3.8%(n=4)50%(n=9)16.7%(n=3) Complex partial M =57 C = %(n=56) 66.7%(2) Simple partial M=8 C=2 100%(n=8) 100%(n=2) Myoclonic M =4 C =2 25%(1)50%(n=2) 100%(n=2)

 Utilization pattern:  Valpraote % monotherapy - 8.5% combination.  Carbamazepine % monotherapy - 1% combination.  Phenytoin - 2.5% monotherapy - 1 combination.

 Utilization pattern of AEDs documented.  Monotherapy more common than combination.  Seizure control better with monotherapy than combination.  Monotherapy is better tolerated with little ADRs.

 Dr. SK Bhattacharya  Dr. Anju Aggarwal  Dr. Neeta Wardhan  Dr. Rachna Gupta.  Department of Pharmacology and Pediatrics  University College of Medical Sciences  Delhi University.