How to Expedite Antiepileptic Medications for Status Epilepticus and Acute Seizure Patients
Nakornratanachai P, MPharm1, Chainirun N, BPharm1,4, Tiamkao S, MD2,4, Lertsinudom S, BCP3,4, Soontornpas R, MPharm1 on behalf of the Integrated Epilepsy Research Group
Affiliation : 1 Pharmacy Department, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand 2 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand 4 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand
Background : Status Epilepticus (SE) is one of the major health problems that require immediate treatment to avoid risk of disability
and death. The key treatment is to stop the symptom within an hour after it has developed. The problems of SE treatments are mostly
caused by delayed diagnosis, incorrect prescription, incorrect rate of administration, inappropriate dilution of medicines.
Objective : In order to provide efficient treatment and reduce the waiting time. The multidisciplinary team, under the lead of Integrated
Epilepsy Research Group, has developed a ready-to-use Status Epilepticus Box (SE Box) for status epilepticus and the acute seizure
at Srinagarind Hospital.
Materials and Methods: A ready-to-use SE Box comprises of 4 medicines; phenytoin, phenobarbital, sodium valproate, and
levetiracetam encloses with information on application of each medicine. The boxes are prepared by pharmacist. Nurses can
immediately use antiepileptic drug follow doctors’ prescriptions.
Results : The review of seizure patients’ records showed an average diagnosis time was 154.77 minutes (1 to 53 hours), an average
time of medical receiving was 41.74 minutes (1 to 150 minutes). The average waiting time for receiving medicine in pharmacy
department was 13.09 minutes, start from raising order by doctors to the medicine dispensing. SE Box can reduce the waiting time
in pharmacy department to zero. Following a doctor’s approval, nurses can administer the medicine to the patients by following the
instructions available in SE Box. The instructions include loading dose, maintenance dose, administer rate, preparing method, and
precautions.
Conclusion : The development of anti-seizure medical system in Srinagarind Hospital, Khon Kaen University, has resulted in the
production of the SE Box, an innovation that is efficient in reducing the waiting time prior to applying medication to the patients.
The SE Box is ready and convenient for use.
Keywords : Status Epilepticus, Refractory Status Epilepticus, Status Epilepticus Drug Box (SE Box)
