Prescribing Pattern of Antiepileptic Drugs in Adults in a South Indian ...

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Elizabeth ST - Prescribing Pattern of Antiepileptic Drugs in Adults in a South Indian Tertiary care HospitalSample Size: A total of 108 In-patients from different units ofmedicine department, who were on AEDs and fulfilled theinclusion criteria were selected and the rest of the patientswere excluded from the study, and the data were collected in awell designed performa.Study period: The retrospective study was conducted for aperiod of 36 months from January 2008 to December 2010.The prospective study was conducted for a period of sixmonths from January 2011 to May 2011.Study Criteria:1) Inclusion Criteria All adult In-patients who were treatedwith AEDs admitted in different units of MedicineDepartment.2) Exclusion Criteria All pregnant women who are onAEDs.3) Source of Data: Data was collected using a well-designedpatient data collection form.1. By reviewing the patient's treatment chart, case sheets ofthe patients.2. From the Medical Record Department of KIMS Hospitaland Research Centre.Preparation of data collection form: Information extractedfrom the case files will include: Demographic data, chiefcomplaint, If he/she is a known case of epilepsy and etiologyof seizure, habits (Smoker/Alcoholic/food habits), adverseeffects, past medical history and past medication history,family history, laboratory details, diagnosis (provisional orconfirmatory). Treatment: AEDs prescribed and prescriptionof the AEDs by generic names. The recommended dosages ofthe AEDs were obtained from the patient case files anddischarge summary(ii) Statistical method.The data of each case file was collected and analyzed by apercentage method.4) Study procedure: After the Institutional EthicsCommittee approval a prospective and retrospective studywas conducted in KIMS Hospital and research centre to studythe prescribing patterns of AEDs in the treatment of epilepsy.RESULTSA retrospective and prospective study 108 epileptic patientswas undertaken to study the prescribing pattern of AED.The study included 108 epileptic patients on antiepilepticsamong whom 66 (61.1%) patients were found to be male and42 (38.9%) patients were females.Majority of the patients 33 (30.55%) were in the age group of40-50 years, followed by 28 (25.92%) of 29-39 years and 16(14.81%) patients were in both age group of 18-28 years and51-61 years. About 15 (13.88%) patients were in the agegroup of 62 years and above. Our data shows that most of thepatients were from the age group of 40-50 years and majorityof the enrolled patients were male as in the other studies.Fig. 1: Graphical representation of the distribution of 108epileptic patients based on the gender.Female: 38.88%Male: 61.11%Fig. 2: Graphical representation of distribution of agegroup with number of patients.Generalized Tonic-Clonic Seizures was found to be moreprevalent 68 (62.96%) patients out of which 41 were malesand 27 were female, followed by Simple Partial Seizures 11(10.18%), 07 were males and 04 were females. Total numbersof Myoclonic Seizures were 08 (7.40%) of which 07 malesand 01 female. Generalized Clonic Seizures 08 (7.40%) ofwhich 01 was male and 07 female. In Complex PartialSeizures 06 (5.55%), 04 were male and 02 were female.Generalized Tonic Seizures of 04 (3.70%) patients, there wereonly male patients. In Atonic Seizures, a total of 03 (2.77%)patients of which 02 male and 01 female.Among all the prescriptions including drugs givenindividually, and in combinations, the usage ofPhenobarbitone accounts for 61 (56.41%) patients of whichIndian Journal of Pharmacy Practice Volume 5 Issue 1 Jan - Mar, 2012 53
Elizabeth ST - Prescribing Pattern of Antiepileptic Drugs in Adults in a South Indian Tertiary care HospitalFig. 3: Graphical representation of distribution of types ofseizures among both the genders38 were male patients and 23 were female patients, followedby phenytoin 38 (35.18%) patients of whom 26 were malepatients and 12 were females. VA usage was 24 (22.22%)patients of which 18 were males and 08 were females.Fig. 4: Graphical representation of prescribing pattern ofAEDs among both gendersCarbamazepine usage was 18 (16.85 %) patients of which, 10were males and 08 were females. 03 (3%) of Lamotrigine, 03patients were males and we did not have any female patientsrecorded.Age distribution of the patients with Generalized TonicClonic Seizures among both the genders: Out of 68 patients ofGeneralized Tonic Clonic Seizures majority were in the agegroup of 29-39 years, 18 (26.47%) patients, 11 were malesand 07 were females. 15 (22.05%) patients were in the agegroup of 40-50 years, 13 were males and 02 were females. 14(20.58%) patients were in the age group of 18-28 years, 07were males and 07 were females.11 (16.17%) patients were inthe age group of 62 years and above, of which 04 were malesand 07 were females. 10 (14.70%) were in the age group of 51-61 years, 06 were males and 04 females.Age distribution of the patients with Simple PartialSeizures among both the genders: Out of 11 patients withsimple partial seizures 04 (36.36%) patients were in the agegroup of 29-39 years and 51-61 years, followed by 03(27.27%) patients were in the age group of 40-50years.Age distribution of the patients with Complex PartialSeizures among both the genders: Out of 06 patients withcomplex seizures 03 (50%) patients were in the age group of40-50 years, of which 02 were females and 01 was male,followed by 02 (33.33%) and 01 (16.66%) patient were in theage group of 29-39 years and 62 years and above respectively.Age distribution of the patients with Atonic Seizuresamong both the genders: Out of 03 patients with 02 (66.66%)patients were in the age group of 40-50 years, followed by 01(33.33%) patient was in the age group of 29-39 years.Age distribution of the patients with Myoclonic Seizuresamong both the genders: Out of 8 patients with MyoclonicSeizures 04 (50%) patients were in the age group of 29-39years, followed by 02 (25%) patients were in the age group of40-50 years, 01 (12.5%) patient each were in the age group of18-28 years and 51-61 years.Age distribution of the patients with Generalized ClonicSeizures among both the genders: Out of 08 patients withGeneralized Clonic Seizures 03 (37.5%) patients were in eachof the age groups of 40-50years, and 62years above, followedby 01 (12.50%) patient each in the age group of 18-28 years,and 51-61 years.Age distribution of the patients with Generalized TonicSeizures among both the genders: Out of 04 patients withGeneralized Tonic Seizures 03 (75%) patients were in the agegroup of 40-50 years, followed by 01(25%) patient was in theage group of 18-28 years.DISCUSSIONWith the rise in the incidence of epilepsy over the past yearsdevelopments of newer AEDs have entered into the currentscenario. The advances in the therapeutical aspects ofepilepsy and the efficacy of monotherapy versus combinationtherapy have not been extensively studied. The beneficialeffects of second generation drugs can also be studiedconduction Drug utilization studies in this area. In our studywe were able to make inferences with regard to the mostcommonly prescribed AED's, most common types epilepsy,the different age group distribution, and the gender mostlikely affected. A total of 108 epileptic patients were included.The incidence of epilepsy was found to be higher in male thanin females and also the incidence of epilepsy increases with anIndian Journal of Pharmacy Practice Volume 5 Issue 1 Jan - Mar, 2012 54
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