Trends of Intravenous Antiepileptic Drugs Used in Patients at Srinagarind Hospital, Thailand
Nuntasaen T, MPharm1,5, Chainirun N, Bpharm1,5, Tiamkao S, MD2,5, Lertsinudom S, BSc, BCP3,5, Pranboon S, MSN4,5 on behalf of theIntegrated 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 Nursing Division, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand 5 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand
Objective : Seizures are considered a major neurological emergency condition that requires appropriate treatment with an aim to
enable the patient to control the seizures. Seizures are dangerous and may result in a high chance of death. Selection of antiepileptic
drugs, especially the IV AEDs is very important in the course of treatment since this can partly contribute to the patient’s ability to
control seizures and the mortality rate from complications can be reduced. Thus, this study aimed at investigating the trend of usage
of intravenous-administered antiepileptic drugs in the standard AEDs and new AEDs groups and finding the costs of drug use so as
to obtain base data and methods for planning improvement of patient care system in the future.
Materials and Methods: This descriptive study was performed by retrospective data collection from the patients receiving IV
antiepileptic drugs at Srinagarind Hospital from January 1, 2005 to December 31, 2016. The patients’ drug use was collected from
electronics database of Srinagarind Hospital’s pharmacy section. The rates of IV AEDs use were studied and comparison was
conducted to obtain the costs ofthe standard and new groups of IV AEDs used.
Results : The patients receivingIV AEDs totaled 9,021 cases, 4,777 being males (52.95%) and 1,734 cases were children younger than
15 years (19.22%). Most of these patients used their Universal Health The Coverage (5,347 cases, 59.27%). In 2016, the proportion
of patients with epilepsy increased 2.2 times or 602 patients from 2005. When comparing the rate of standard AEDs use (Phenytoin,
Phenobabital, and Sodium valproate) with new AED (Levetiracetam), it was found that the use of standard AEDs decreased (100%
in 2005 compared to 61.83% in 2016). The drug in the standard group with the highest decreasing prescription rate was Phenytoin
(62.17% in 2005 compared to 45.38% in 2016, or a decrease of 16.79%). Nevertheless, when comparing the percentages of
prescription, Phenytoin was still found to be the mostly chosen IV AED for the patients (45.38%), followed by Levetiracetam
(38.17%) and Sodium valproate (10.38%). Comparison of the costs of IV AEDs prescribed shows yearly increase. The highest cost
resulting from increase of prescription was found in Levetiracetam, at the cost of 154,455.50 USD or an increase of 52.45% followed
by Phenytoin at the cost of 69,710.07 USD or an increase of 23.67%.
Conclusion : The research indicates that the trend of IV AEDs use was in new AEDs group, and their costs arising from increased
prescription were also higher. This shows the changing trend in the selection of drugs by physicians. The result here can be used
as the basic data for planning the service and care systems for the patients in the future.
Keywords : Trends, Intravenous antiepileptic drugs
