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Drug utilization pattern of antiseizure drugs and their adverse effects in the pediatric population, in a tertiary care hospital attached to a medical college

Rusva A. Mistry, Krunal C. Solanki, Hiren K. Prajapati, Tejas M. Doshi, Hiren R. Trivedi.

Abstract
Background: Epilepsy is “a condition characterized by recurrent (two or more) seizure, unprovoked by any immediate identified cause.” The desired outcome of antiseizure drug (ASD) therapy is to be seizure-free throughout the rest of life. The objective was to study the utilization pattern and adverse drug reactions (ADRs) associated with the use of ASDs in pediatric outpatients in epilepsy clinic.
Methods: This cross-sectional, observational and single center study was carried out over a period of 1 year in 430 pediatric patients. Analyzed data included demographic details and drugs prescribed in respective seizure types along with ADRs due to ASDs.
Results: In a total 430 patients analyzed, seizure were most commonly observed in boys (69.8%) in 6-10 year of age (45.3%), with a positive family history in (16%), with no specific cause of seizure in (71.6%), with most common type was focal seizure in (62.3%), which was mainly treated with carbamazepine (73.8%). Most common ADR was irritability (32.2%) with Valproate being main drug. 87.3% ADRs were in “possible” as per World Health Organization causality assessment scale, 94.9% ADRs were “mild” as per Hartwig and Siegel severity assessment scale and 98.3% ADRs were “preventable” as per Schumock and Thornton preventability scale.
Conclusion: Focal seizure was most common type of seizure observed mainly in boys of 6-10 year with carbamazepine as mainly prescribed drug. Use of appropriate ASDs in the majority of patients as per guidelines, has decreased number of ADRs in our study. Prescribing drugs were mainly from essential drug list and by generic names.

Key words: Epilepsy, Drug utilization pattern, Adverse drug reaction



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