Citation

Crepeau AZ, Moseley BD, Wirrell EC. Drug Healthc. Patient Saf. 2012; 4(1): 39-54.

Copyright

(Copyright © 2012, Dove Press)

DOI

unavailable

PMID

unavailable

Abstract

Epilepsy is one of the most common neurological disorders in the pediatric age range, and the majority of affected children can be safely and effectively treated with antiepileptic medication. While there are many antiepileptic agents on the market, specific drugs may be more efficacious for certain seizure types or electroclinical syndromes. Furthermore, certain adverse effects are more common with specific classes of medication. Additionally patient-specific factors, such as age, race, other medical conditions, or concurrent medication use may result in higher rates of side effects or altered efficacy. Significant developmental changes in gastric absorption, protein binding, hepatic metabolism, and renal clearance are seen over the pediatric age range, which impact pharmacokinetics. Such changes must be considered to determine optimal dosing and dosing intervals for children at specific ages. Furthermore, approximately one third of children require polytherapy for seizure control, and many more take concurrent medications for other conditions. In such children, drug-drug interactions must be considered to minimize adverse effects and improve efficacy. This review will address issues of antiepileptic drug efficacy, tolerability and ease of use, pharmacokinetics, and drug-drug interactions in the pediatric age range. © 2012 Crepeau et al, publisher and licensee Dove Medical Press Ltd.

Language: en

Keywords

human; suicide; insomnia; abdominal pain; liver failure; depression; risk assessment; kidney disease; mood disorder; risk factor; review; fatigue; pancreatitis; anorexia; vomiting; mental disease; anticonvulsive agent; behavior disorder; hydrocortisone; cognitive defect; sedation; somnolence; vertigo; drowsiness; gastrointestinal symptom; tonic clonic seizure; electrolyte disturbance; drug safety; placebo; drug blood level; benzodiazepine derivative; heart muscle conduction disturbance; carbamazepine; drug efficacy; drug tolerability; nausea; tremor; disease exacerbation; irritability; drug megadose; unindexed drug; valproic acid; drug distribution; Pharmacokinetics; neurologic disease; felbamate; lamotrigine; phenobarbital; side effect; topiramate; vigabatrin; attention deficit disorder; metabolic disorder; agitation; heart arrhythmia; heart disease; phenytoin; pregabalin; Antiepileptic drugs; primidone; liver toxicity; clonazepam; drug absorption; gastrointestinal disease; child care; cytochrome P450; drug response; low drug dose; drug contraindication; hyponatremia; corticotropin; tiagabine; ataxia; drug monitoring; etiracetam; oxcarbazepine; zonisamide; metabolic acidosis; paresthesia; nephrolithiasis; teratogenicity; aplastic anemia; diplopia; dizziness; drug eruption; drug hypersensitivity; increased appetite; Stevens Johnson syndrome; eye disease; hyperactivity; drug bioavailability; ovary polycystic disease; bone density; drug induced headache; skin disease; outcome assessment; prednisolone; closed angle glaucoma; drug excretion; genital system disease; Drug-drug interactions; piracetam; brain maturation; bone disease; clobazam; drug protein binding; drug dose comparison; bone marrow disease; Lennox Gastaut syndrome; thinking impairment; myoclonus epilepsy; drug transformation; ethosuximide; rufinamide; visual field defect; harkoseride; benign childhood epilepsy; childhood absence epilepsy; inborn error of metabolism; prolonged PR interval; severe myoclonic epilepsy in infancy; short QT interval; stiripentol; sultiame; West syndrome