Lingam, A (2016) A Comparative Study of Remission Occurrence in the Mono and add on Therapies during the Treatment of Epileptic Seizures and the Evaluation of Patients Knowledge on First Aid in Tertiary Care Hospital. Masters thesis, K.M.College of Pharmacy, Madurai.
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Abstract
INTRODUCTION: While the Evaluation and treatment of patient with seizures (or) epilepsy, is often challenging. Modern therapy provides many patient with seizure control. After a first seizure evaluation should focus on excluding an underling neurologic or medical condition assessing the relative risk of seizure reoccurrence & determining whether treatment is indicated. Successful management of patient with recurrent seizure begins with the establishment of accurate diagnosis of epilepsy syndrome followed by treatment using an appropriate medication in a manner to optimize the efficacy. The goal of AED’s therapy is to completely control seizures with producing Un acceptable medication side effects. Patients who do not achieve complete seizure control should refer to an epilepsy specialist. Since new medication and surgical treatment offers patients unprecedented options in seizure control. Newly diagnosed epileptic patients and principles of treatment in chronic epilepsy help in designing steps to improve the safety of drug use in the hospital working setup. Better health care practice could be ensured by applying this knowledge to individual patients.Present study was undertaken to understand the treatment outcome of AED’s observed in neurology unit of a teaching hospital with regarding to demographics of patients, choice of prescribed AED’s usual dosing regimens and faster routine incremental and decrimental rates, management of seizures & identify precipitating factors of epilepsy. AIM OF THE STUDY: To study the comparison between the remission occurrence while giving therapies (Mono/Add on) including AED’s in the treatment of epileptic seizures & evaluate the patients access to medical care who were under the treatment of General Medicine Department of New Life Society, Bethesda Hospital, Tuticorin. OBJECTIVES OF THE STUDY: 1. To identify the various precipitating factors & emotional symptoms, to assess the side effects caused by the drugs. 2. To know about the choice of therapies (Mono/Add on) including AED’s in treatment of Epileptic seizures. 3. To evaluate the respondents access to medical care belongs to regional and urban population. 4. To study the epidemiological factors and etiological factors of epilepsy. 5. To develop guidelines for the first aid treatment of epilepsy. 6. To develop guidelines for the management of epilepsy and seizures. 7. To give effective patient counselling for epilepsy patient. 8. To study the management of the adverse drug reaction and side effects. 9. To find out the remission occurrence in the mono and add on therapy in epilepsy. DISCUSSION: The concept of treatment of seizures with modern therapy is relatively new in India. In developing countries the neurology treatment is become burden to the people. Due to rapid growth in population, general lack of education, health awareness and socio economic status. There is no racial geographical or social class boundaries of seizures occurs in both genders, at all ages, especially in childhood, adolescents and increasingly in ageing population, while the condition can have profound physical and psychosocial consequences, appropriate treatment can prevent long term damage. While there is no cure for the condition there are various wayspeople can control or manage symptoms to improve their quality of life particularly if the condition is identified and managed early. In this study a total of 50 patients comprising 22 (44%) males & 28 (56%) female were selected from the department of general medicine, New Life Society, Bethesda Hospital, Tuticorin. In the present study the percentage privilege of female patients is high when compared with male patients in the study population. For the treatment of epilepsy in women monotherapy is recommended during the reproductive years to reduce the risk teratogenicity seen with poly pharmacy. On the classification of patients according to the age group the maximum number patients according to the age group the maximum number of patients were under the age group of 36-45 (30%).Other age group in 15-25 (22%), 26-35 (26%), 46-55(16%), 56-65(6%).This results indicates that most of the epilepsy patients were under the age group of 26-45. Classification of Illness table shows, mildly ill patients are mostly in 20 (40%) moderately ill patients 10, markedly ill patients 6, Border line ill patient 14. This result showed severity of illness more in 36-45 years (32%). The number of married patients were 39(78%) compared to unmarried patients 11(22%) . CONCLUSION: The incidence of epilepsy is 24-53% of population in developing countries. However over 30% of people with epilepsy or seizure don’t have seizure control even with the best available medications. AED’s therapy is the main stay of treatment for most patients with epilepsy. The overall goal is to completely prevent seizures without causing any untoward side effects, preferably with single medication and a dosing schedule that is easy for the patient to follow. Because the response to any anti epileptic drug is unpredictable so patient should be carefully educated about approach to therapy. Most of the generalized seizure patient take monotherapy. In this adverse effect occurrence was less compared to add on therapy. Add –on-therapy taken long term treatment with more side effect. But in monotherapy duration of treatment short with less side effect .The vast majority of patients had remission by mono therapy treatment .Co operation between the patient, physician and pharmacist results best possible outcome. There is a long tradition of treating epilepsy patients with two or more AEDs. However, in the past decade monotherapy has emerged as the ultimate treatment strategy for both newly-diagnosed and long-term patients because of fewer side effects, better compliance, less teratogencity and lower cost. Reducing AED polytherapy to monotherapy frequently reduces the burden of adverse effects and may also improve seizure control. AED monotherapy remains the optimal approach for managing most patients with epilepsy. Tips regarding first aid for making the people physically and mentally ready to help the people who were getting sudden occurrence of seizures. By this way we can get tremendous change in reducing Sudden Unexpected Deaths in Epilepsy (SUDEP) and we were succeeded in achieving our main goal to maximize the quality of the life by minimizing the seizures activity.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.261440056 |
| Uncontrolled Keywords: | Comparative Study ; Remission Occurrence ; Mono Therapies ; Epileptic Seizures ; Patients Knowledge ; First Aid ; Tertiary Care Hospital. |
| Subjects: | PHARMACY > Pharmacy Practice |
| Depositing User: | Ravindran C |
| Date Deposited: | 12 Apr 2018 09:33 |
| Last Modified: | 12 Apr 2018 10:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6955 |
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