Clinical pharmacist′s pharmaceutical care for a child with intracranial infection complicated with epilepsy
GAO Bei1 WANG Jing2 GE Bin1▲
1. Department of Pharmacy, Gansu Provincial Hospital, Gansu Province, Lanzhou 730000, China;
2. College of Pharmacy, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan 750004, China
When anti-infective drugs and anti-epileptic drugs are treated simultaneously, on the one hand, attention should be paid to the possible epileptogenic adverse reactions of antiinfective drugs, and on the other hand, attention should be paid to the interaction between antiinfective drugs and antiepileptic drugs. In this paper, clinical pharmacists provided pharmaceutical care for a child patient with intracranial infection complicated with epilepsy for many times.Including the reorganization of medical orders to analyze the cause of epilepsy in children. It is considered that the cause of poor epilepsy control may be the interaction between Meropenem and Sodium Valproate resulting in the reduction of sodium valproate plasma concentration. The clinical characteristics of the interaction were summarized by literature review. Combined with the pathophysiological characteristics of the children, the epileptogenic nature of anti-infective drugs, the adverse reactions of anti-epileptic drugs and many other factors, to assist doctors to re-formulate anti-infective and anti-epileptic treatment plans. Finally, the infection and epilepsy symptoms of children are effectively controlled. The pharmaceutical care provided by clinical pharmacists throughout the treatment of children not only ensures the safety and effectiveness of the treatment of children, but also provides a reference for the formulation of drug treatment plan for such patients.
Wanleenuwat P,Suntharampillai N,Iwanowski P.Antibioticinduced epileptic seizures:mechanisms of action and clinical considerations[J].Seizure,2020,81:167-174.
[2]
Zaccara G,Lattanzi S.A review of pharmacokinetic drug interactions between antimicrobial and antiseizure medications in children[J].Epileptic Disord,2021,23(2):229-256.
[3]
Beghi E.The Epidemiology of Epilepsy[J].Neuroepidemiology,2020,54(2):185-191.
[4]
DeGrauw X,Thurman D,Xu L,et al.Epidemiology of traumatic brain injury-associated epilepsy and early use of anti-epilepsy drugs: An analysis of insurance claims data,2004-2014[J].Epilepsy Res,2018,146:41-49.
[5]
Farghaly WM,Abd Elhamed MA,Hassan EM,et al.Prevalence of childhood and adolescence epilepsy in Upper Egypt (desert areas)[J].Egypt J Neurol Psychiatr Neurosurg,2018,54(1):34.
Cannon JP,Lee TA,Clark NM,et al.The risk of seizures among the carbapenems:a meta-analysis[J].J Antimicrob Chemother,2014,69(8):2043-2055.
[8]
中国抗癫痫协会.临床诊疗指南—癫痫病分册[M].北京:人民卫生出版社,2015:82-89.
[9]
Glauser T,Shinnar S,Gloss D,et al.Evidence-Based Guideline:Treatment of Convulsive Status Epilepticus in Children and Adults:Report of the Guideline Committee of the American Epilepsy Society[J].Epilepsy Curr,2016,16(1):48-61.
[10]
Al-Quteimat O,Laila A.Valproate Interaction With Carbapenems:Review and Recommendations[J].Hosp Pharm,2020,55(3):181-187.
[11]
Chai PYC,Chang CT,Chen YH,et al.Effect of drug interactions between carbapenems and valproate on serum valproate concentration:a systematic review and meta-analysis[J].Expert Opin Drug Saf,2021,20(2):215-223.
[12]
Chen IL,Lee CH,Hsiao SC,et al.Interactions between carbapenems and valproic acid among the patients in the intensive care units[J].J Crit Care,2021,62:151-156.
[13]
Wen ZP,Fan SS,Du C,et al.Drug-drug interaction between valproic acid and meropenem:a retrospective analysis of electronic medical records from neurosurgery inpatients[J].J Clin Pharm Ther,2017,42(2):221-227.
[14]
Miranda Herrero MC,Alcaraz Romero AJ,Escudero Vilaplana V,et al.Pharmacological interaction between valproic acid and carbapenem:what about levels in pediatrics?[J].Eur J Paediatr Neurol,2015,19(2):155-161.
Wu CC,Pai TY,Hsiao FY,et al.The Effect of Different Carbapenem Antibiotics (Ertapenem,Imipenem/Cilastatin,and Meropenem)on Serum Valproic Acid Concentrations[J].Ther Drug Monit,2016,38(5):587-592.
[17]
Frantoni AJ,Colmertauer JL,Linder KE,et al.A Retrospective Case Series of Concomitant Carbapenem and Valproic Acid Use:Are Best Practice Advisories Working?[J].J Pharm Pract,2021,38(5):587-592.
National Institute for Health and Care Excellence.Epilepsies in children,young people and adults [EB/OL].[2022-04-27]https://www.nice.org.uk/guidance/ng217.