scholarly journals Diagnosis of Pregnant Women with Seizures at Tikur Anbessa Hospital

2021 ◽  
pp. 1-6
Author(s):  
Beliyu Ejo Kebede ◽  
◽  
Meseret Adugna Geleta ◽  
Keyword(s):  
Antiepileptic Drugs ◽  
Breast Feeding ◽  
Dual Therapy ◽  
Drug Regimen ◽  
Prescribing Patterns ◽  
Seizure Type ◽  
Healthy Children ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Complex Partial Seizures

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.

scholarly journals Diagnosis of Pregnant Women with Seizures at Tikur Anbessa Hospital

2021 ◽  
pp. 1-6
Author(s):  
Beliyu Ejo Kebede ◽  
◽  
Meseret Adugna Geleta ◽  
Keyword(s):  
Antiepileptic Drugs ◽  
Breast Feeding ◽  
Dual Therapy ◽  
Drug Regimen ◽  
Prescribing Patterns ◽  
Seizure Type ◽  
Healthy Children ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Complex Partial Seizures

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.

Breast-Feeding and Serum p,p′DDT Levels among Mexican Women of Childbearing Age: A Pilot Study

2001 ◽  
Vol 87 (3) ◽  
pp. 131-135 ◽  
Author(s):  
Lizbeth López-Carrillo ◽  
Luisa Torres-Sánchez ◽  
Jacqueline Moline ◽  
Karen Ireland ◽  
Mary S. Wolff
Keyword(s):  
Pilot Study ◽  
Breast Feeding ◽  
Mexican Women ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Pharmacotherapeutic Issues for Women of Childbearing Age with Epilepsy

1998 ◽  
Vol 32 (7-8) ◽  
pp. 794-801 ◽  
Author(s):  
Shu-Ing Chang ◽  
James W McAuley
Keyword(s):  
Drug Interactions ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Seizure Activity ◽  
Clinical Symptoms ◽  
Pharmacy Practice ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Medline Search ◽  
Drug Concentrations

James W McAuley BSPharm PhD, Assistant Professor of Pharmacy Practice and Administration and Neurology, Colleges of Pharmacy and Medicine, The Ohio State University OBJECTIVE: To provide an overview of key pharmacotherapeutic issues in epilepsy for the woman of childbearing potential. DATA SOURCES: A MEDLINE search (1966–1997) was done to identify pertinent literature. Chapters in epilepsy textbooks, pregnancy registries, and their respective bibliographies were also evaluated. STUDY SELECTION AND DATA EXTRACTION: All identifiable sources written in English were evaluated. DATA SYNTHESIS: Epilepsy is a common neurologic disorder. It is estimated that nearly 1 million American women of childbearing age have epilepsy. There are many women's health issues in epilepsy. These include menstrual cycle influences on seizure activity, contraceptive–antiepileptic drug interactions, pharmacokinetic changes during pregnancy, teratogenicity of antiepileptic drugs, breast-feeding, and quality of life. These issues challenge both the woman with epilepsy and the many healthcare providers involved in her care. This article reviews these issues and makes recommendations. It addresses both the first-generation antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, valproic acid) and the newer or second-generation agents (felbamate, gabapentin, lamotrigine, topiramate, tiagabine). CONCLUSIONS/RECOMMENDATIONS: Drug interactions between enzyme-inducing antiepileptic drugs and contraceptives are well documented. Higher doses of oral contraceptives or a second contraceptive method are suggested if epileptic women use an enzyme-inducing antiepileptic drug. Planned pregnancy is highly recommended and counseling before conception is crucial. Prepregnancy counseling should include, but is not limited to, folic acid supplementation, optimal control of seizure activity, monotherapy with the lowest effective antiepileptic drug dose, and medication adherence. Patient information should be provided about the risk of teratogenicity and the importance of prenatal care. Antiepileptic drug dosage adjustments may be necessary and should be based on clinical symptoms, not solely on serum drug concentrations. While the future holds promise for many aforementioned women's issues in epilepsy, many questions remain to be answered.

scholarly journals Epilepsy: Clinical Considerations in Women of Childbearing Age

2013 ◽  
Vol 12 (4) ◽  
pp. 364-369 ◽  
Author(s):  
A Ahmad
Keyword(s):  
Drug Exposure ◽  
Seizure Control ◽  
Medical Science ◽  
Drug Regimen ◽  
Subsequent Pregnancy ◽  
Elective Cesarean Section ◽  
Childbearing Age ◽  
Unexpected Death ◽  
Complex Partial Seizures ◽  
Elective Cesarean

Epilepsy is the commonest chronic neurological disorder to complicate pregnancy, having an incidence of 0.15% to 10%. Sudden unexpected death in epilepsy is the principal cause of death, and seizure control is the key to minimizing this risk. The aim of antenatal care is to optimize seizure control. The lowest dose of antiepileptic medication that protects against seizures should be chosen. Non-adherence to treatment may present a greater risk to the developing fetus than antiepileptic drug exposure. Adequate rest and sleep is mandatory for epileptic women. The normal anti epileptic drug regimen should be continued during labor. An elective cesarean section should be considered if there have been frequent tonic clonic or prolonged complex partial seizures towards the end of pregnancy. Breast feeding is not contraindicated. Appropriate contraceptive advice should be given. The importance of pre conceptual care in a subsequent pregnancy should be reiterated. DOI: http://dx.doi.org/10.3329/bjms.v12i4.12818 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 364-369

Differing Physician Perceptions of Oxcarbazepine and Levetiracetam for Women of Child- Bearing Age: A Physician Survey Based Study

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Avani Shukla ◽  
Keyword(s):  
Antiepileptic Drugs ◽  
Young Women ◽  
Significant Proportion ◽  
Reproductive Age ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Women Of Reproductive Age ◽  
Physician Perceptions ◽  
Child Bearing ◽  
Patient Profiles

Background: Young women of reproductive age constitute a significant proportion of India's epilepsy patient population. Doctors take several considerations into account while prescribing antiepileptic drugs (AEDs) to young women to balance the risk of seizures with other concerns. Objective: To understand how doctors perceive various AEDs regarding their safety, efficacy, and other attributes for women of childbearing age. Materials and Methods: This study consisted of a survey designed to understand the usage and perception of 12 antiepileptic drugs in the Indian market. The survey respondents of this study were neurologists, neurosurgeons, and psychiatrists from all over India, from private or government setups, and with different experience and patient load levels. Results: In the study, 93% of all survey respondents indicated that they avoid one or more AEDs in women of childbearing age, making it a significant consideration. This consideration is a specialty split for the second- generation AEDs, Oxcarbazepine, and Levetiracetam. Approximately three times more Neurosurgeons avoid Oxcarbazepine as compared to neurologists and psychiatrists who use this drug. In the case of Levetiracetam, mainly only psychiatrists avoid it for women of reproductive age. Apart from the personal experience of doctors, factors other than teratogenic risks, such as changes in reproductive hormone levels, may have contributed to the observed difference in perception. Conclusion: The study highlights doctors ‘differing perceptions for highly used drugs among all specialties emphasizing the need to determine if such differences in perception exist between other AEDs for various types of patient profiles.

Multiple Sclerosis

2017 ◽  
Author(s):  
Tamara B. Kaplan ◽  
Marcelo Matiello
Keyword(s):  
Multiple Sclerosis ◽  
Breast Feeding ◽  
Relapse Rate ◽  
Large Scale ◽  
First Trimester ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Third Trimester ◽  
Disease Modifying Therapies ◽  
Animal Data

Multiple sclerosis (MS) often affects women of childbearing age. There are many issues to consider when counseling women about their disease and treatment during this time. The Pregnancy in Multiple Sclerosis (PRIMS) study, published in 1998, is the best large-scale prospective study published to date. Based on this trial, and those that followed, it is recognized that the rate of relapse in MS decreases during pregnancy, especially during the third trimester, but there is a significant increase in relapse rate in the first three months postpartum. If relapses do occur during pregnancy, women are often treated with methylprednisolone, but this is generally avoided in the first trimester. Disease-modifying therapies (DMTs) are usually discontinued during preconception, pregnancy, and while breast-feeding. DMTs are classified under different FDA pregnancy categories based on human and animal data. Breast-feeding may influence postpartum relapse rate, but the true effect continues to be debated.

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