Patterns of antiepileptic drugs use in epileptic pediatric patients in Jordan

Abstract

Objectives:To determine prescribing patterns of antiepileptic drugs (AEDs) in pediatric patients with confirmed diagnosis of epilepsy, and to provide knowledge of general practice of physicians.Methods:The study was a multi-center cross-sectional observational study, in specialized clinics for management of epilepsy in north, central and south Jordan. This study was conducted from January 2014 to July 2014. These were 3 from university tertiary care hospitals and 4 from governmental tertiary care hospitals.Results:A total of 694 pediatric patients were included. Monotherapy AED use had the highest frequency 465 (67.0%), followed by dual therapy 162 (23.3%). The frequency of monotherapy in university hospitals was lower than governmental hospitals (p<0.05); however, Polytherapy was more frequent in younger children. Two old AEDs were most frequently prescribed as a monotherapy; Valproic acid 235 (50.5%) and carbamazepine 155 (33.3%). The most common combination in dual therapy was valproic acid with carbamazepine 28 (17.3%). The second most common combinations were carbamazepine with levetiracetam 21 (13.0%) or valproic acid with levetiracetam 20 (12.3%).Conclusion:Older AED remain first line drugs for use in both monotherapy and combination therapy for epileptic disorders. Polytherapy is associated with younger kids and being treated in a university hospital.

Self‐medication misuse in the Middle East: a systematic literature review

“…Most of the studies were cross-sectional descriptive studies often using self-administered questionnaires, face-to-face interviews, or pharmacists' perception. Many studies report data based on pharmacists' perceptions of the problem of misuse and the profile of those they considered to be affected, such as reported by Albsoul-Younes et al (2010), Elhoseeny et al (2013. These study designs are similar to those conducted in Scotland (Paxton and Chapple 1996;Matheson et al 2002).…”

“…Studies based on pharmacists' approaches appeared to generate more detailed and varied descriptions of medicines that may be misused. In Jordan, for example, antibiotics were commonly cited by pharmacists as being misused, as regulations restricting their supply were not always enforced (Albsoul-Younes et al 2010). Similar studies were conducted in Palestine and Egypt by Sweileh et al (2004) and Elhoseeny et al (2013) based on perception of community pharmacists.…”

“…Cough/cold products and laxatives Sweileh et al (2004) and Albsoul-Younes et al (2010) reported that antitussives, analgesics, antihistamines, decongestants, and laxatives were identified by pharmacists as misused medicines (Sweileh 2004). The antitussive products most misused were those containing the following combinations: (codeine phosphate/pseudoephedrine/ triprolidine) (53.6%) or (ephedrine/ammonium chloride/ codeine phosphate/pheniramine maleate) (5.2%).…”

Effect of early postnatal exposure to valproate on neurobehavioral development and regional BDNF expression in two strains of mice

“…While a number of treatments have been developed for pediatric seizures, valproate is still heavily utilized in many pediatric populations around the world, with prescribing rates as high as 50% in Jordan [3], 40% in Singapore [4], 25% in India [5] and 22% in the US [6]. While valproate is known to have teratogenic effects on fetal development, the impact of pediatric exposure on neurobehavioral development has remained less clear [7].…”

Pharmacogenetics of carbamazepine

“…детей с эпилепсией в Хорватии показатель КМЗ уступал только препаратам вальпроевой кислоты (ВК) (37% против 51%) [8]. Около 33,3% детей с эпилепсией в Иордании [9] получали КМЗ в 2014 г., и до 2013 г. КМЗ был наиболее часто назначаемым ПЭП пациентам в Бангладеш в возрастной группе 11-30 лет (67%) [10]. В развитых странах (Австралия [11], Норвегия [12], Гонконг [13], и др.)…”