Estudio de prescripción-indicación en pacientes que reciben antiepilépticos en Colombia

Machado‐Alba, Jorge Enrique; Calvo-Torres, L. Felipe; García-Betancur, Santiago; Aguirre-Novoa, A.; Bañol-Giraldo, Alejandra M.

doi:10.1016/j.nrl.2015.06.015

Cited by 14 publications

(4 citation statements)

References 36 publications

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“…Actualmente, se emplea antes de esta edad en niños con crisis focal y crisis focal con evolución a tónico clónico bilateral, probablemente relacionado con su amplio margen de seguridad, perfil farmacocinético lineal y menor incidencia de reacciones adversas a medicamento (RAM) e interacciones, comparativamente con otros AE. [8][9][10][11] Sus características farmacocinéticas/ farmacodinámicas incluyen una absorción casi completa tras la administración oral y biodisponibilidad cercana al 100 %. Las concentraciones plasmáticas máximas ocurren en una hora y las concentraciones en estado estacionario se alcanzan en dos días.…”

Section: Introductionunclassified

“…El aclaramiento corporal del LEV en niños es del 30 % al 40 % superior comparado con adultos y, por tanto, se recomienda que los niños tengan una dosis diaria de mantenimiento por peso corporal total (20-60 mg/kg/día) dividida en dos dosis. 10,11 El buen perfil del LEV, dada su farmacología, parece prometedor y lo harían un AE "ideal", sin embargo, todavía existe la necesidad de demostrar la efectividad y seguridad sostenida en el tiempo.…”

Section: Introductionunclassified

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Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile

2024

Arch Argent Pediat

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Introducción. El levetiracetam (LEV) es un antiepiléptico aprobado por el Instituto de Salud Pública de Chile como terapia concomitante en crisis epilépticas en niños mayores de cuatro años. Sin embargo, es ampliamente indicado desde el periodo neonatal, lo que hace necesario evaluar su utilización fuera de ficha técnica.Objetivo. Determinar el perfil de prescripción-indicación de LEV en el tratamiento de las crisis epilépticas en menores de cuatro años en un hospital de alta complejidad del sur de Chile. Población y método.Estudio observacional, descriptivo y retrospectivo. Se revisaron las historias clínicas de quienes iniciaron tratamiento con LEV entre 2014 y 2019, y se recopilaron datos sobre variables sociodemográficas, farmacológicas y clínicas. El análisis se basó en la descripción del perfil de los pacientes, prescripción, seguimiento y seguridad.Resultados. Se incluyeron 68 pacientes: 40 (58,8 %) de sexo masculino, 49 (72,1 %) con edad gestacional ≥ 37 semanas. La etiología principal de la epilepsia fue de tipo estructural (35,3 %); el LEV se utilizó principalmente en niños diagnosticados con malformación del sistema nervioso central (17,6 %) y predominó la monoterapia (55,9 %). En el 50 % se usó LEV para crisis focales. Cinco niños (7,3 %) presentaron trastornos de tipo psiquiátrico clasificados como probables reacciones adversas al medicamento. Conclusión.El LEV se utilizó en niños con diferentes diagnósticos con baja frecuencia de eventos adversos. El perfil de utilización varió en los diferentes grupos etarios. Es necesario identificar en futuros estudios la efectividad especialmente en el recién nacido y en epilepsias refractarias.

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Section: Introductionunclassified

Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile

2024

Arch Argent Pediat

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“…LEV is currently used before this age in children with focal seizures and focal seizures that progress to bilateral tonic-clonic seizures, probably related to its broad safety margin, linear pharmacokinetic profile, and lower incidence of adverse drug reactions (ADRs) and interactions, compared to other AEDs. [8][9][10][11] Its pharmacokinetic and pharmacodynamic characteristics include almost complete absorption after oral administration and a bioavailability close to 100%. Peak plasma concentrations occur within 1 hour and steady state concentrations are reached within 2 days.…”

Section: Introductionmentioning

confidence: 99%

“…The body clearance of LEV in children is 30% to 40% higher compared to adults and, therefore, it is recommended that children receive a daily maintenance dose per total body weight (20-60 mg/kg/day) divided into 2 doses. 10,11 The adequate profile of LEV, given its pharmacology, seems promising and would make it an "ideal" AED; however, it is still necessary to demonstrate its sustained effectiveness and safety over time.…”

Section: Introductionmentioning

confidence: 99%

Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile

2024

Arch Argent Pediat

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Introduction. Levetiracetam (LEV) is an antiepileptic drug approved by the Chilean Institute of PublicHealth as concomitant therapy for epileptic seizures in children older than 4 years of age. However, it is widely prescribed from the neonatal period, which makes it necessary to evaluate its off-label use.Objective. To determine the prescription-indication profile of LEV in the treatment of epileptic seizures in children younger than 4 years in a tertiary care hospital in southern Chile.Population and method. Observational, descriptive, and retrospective study. The medical records of patients who started treatment with LEV between 2014 and 2019 were reviewed, and data on sociodemographic, pharmacological, and clinical variables were collected. The analysis was based on the description of the profile of patients, prescriptions, follow-up, and safety.Results. A total of 68 patients were included: 40 (58.8%) were males, 49 (72.1%) were born at a gestational age ≥ 37 weeks. The main etiology of epilepsy was structural (35.3%); LEV was mostly used in children diagnosed with central nervous system malformation (17.6%), and monotherapy was the prevailing dosage (55.9%). LEV was used for focal seizures in 50% of cases. Five children (7.3%) had psychiatric disorders, classified as probable adverse drug reactions. Conclusion.LEV was used in children with various diagnoses, with a low rate of adverse events. The profile of drug use varied in the different age groups. Future studies are needed to identify effectiveness, especially in newborn infants and patients with refractory epilepsy.

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Prescription profile of pyridostigmine use in a population of patients with myasthenia gravis

et al. 2017

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We determined the pyridostigmine prescription pattern in a population of patients with myasthenia gravis (MG). A descriptive cross-sectional study was conducted by using a prescription database of 3.5 million individuals from which patients who had been diagnosed with MG and for whom pyridostigmine had been prescribed were selected. A total of 306 outpatients with MG were found, and 258 were receiving pyridostigmine (mean age 53.0 ± 18.0 years). The calculated prevalence of MG was 86.7 cases per million persons. Monotherapy was used by 53.1% of the patients, prednisolone was used by 21.7%, and 30.2% used other immunomodulators. Medications for other comorbidities were taken by 74.8% of the patients, and 43.4% had prescriptions that could potentially trigger worsening symptoms. Pyridostigmine is being prescribed at doses close to the defined daily doses predominantly as monotherapy. A high proportion of patients were also prescribed a medication that could aggravate their condition, including some that can trigger a myasthenic crisis. Muscle Nerve 56: 1041-1046, 2017.

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Estudio de prescripción-indicación en pacientes que reciben antiepilépticos en Colombia

Abstract: In Colombia, antiepileptic drugs are being used for indications other than those originally intended. Monotherapy is the most commonly used treatment approach, together with the use of classic antiepileptic drugs.

Cited by 14 publications

References 36 publications

Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile

Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile

Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile

Prescription profile of pyridostigmine use in a population of patients with myasthenia gravis

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