CLINICAL AND PHARMACEUTICAL MANAGEMENT OF AN EPILEPTIC PATIENT; A CASE REPORT
Anam Maqsood, Farah Azhar
Riphah Institute of Pharmaceutical Sciences, Riphah International University, G-7/4, 7th Avenue, Islamabad, Pakistan.
Keywords: Epilepsy, Phenobarbitone, Carbamazepine, Combination therapy
Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. There is geographic variation in the incidence of epileptic syndromes likely to be associated with genetic and environmental factors, although as yet causality has not been fully established. The complete range of etiologies in the general population is not known. Few predictors of outcome are recognized and it is difficult to prognosticate in any individual case. Knowledge is patchy about the epidemiology of sudden unexpected death in epilepsy. Future epidemiological research needs to address these issues if we are to progress. A 21 years old male with epilepsy came to the local hospital, Rawalpindi with chief complaints of body stiffness , unconsciousness, constipation and unable to swallow food for 16 days. His physical examination showed blood pressure 110/70 mm Hg, pulse 80 per minute, temperature a febrile.. On the basis of his physical and medical examination, the physician prescribed tablet Phenobarbitone 15mg oral BID (two times a day); tablet Tegral® (carbamazepine) 200 mg oral BID; tablet Famot® (famotidine) 40 mg oral TDS (three times a day). Prescribed doses of Famotidine and Carbamazepine are according to the reference book recommendations but dose of Phenobarbitone is found to be less than recommendations of reference book. The main protocol of treatment is to avoid the occurrence of seizures by maintaining an effective dose of antiepileptic drugs which are adjusted to give maximum therapeutic outcomes with minimum adverse consequences. Therefore, for the treatment of epilepsy a careful adjustment of doses is necessary, starting with low doses and increases gradually until seizures are controlled and there are less significant adverse effects. Therefore; the comprehensive clinical examination and therapeutic care is needed that will help to avoid the undesired health related consequences.
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