Evaluación de la efectividad del tratamiento con dos fármacos antiepilépticos en pacientes con poca respuesta a la monoterapia. Seguimiento de un año. Hospital Regional 2 IESS Dr. Teodoro Maldonado Carbo
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La epilepsia es una afección crónica caracterizada por la repetición de paroxismos debido a la activación súbita, simultánea y anormalmente intensa de un gran número de neuronas cerebrales. Estos paroxismos se traducen clínicamente por crisis epilépticas; siempre repentinas, con aspectos clínicos variables tanto generalizadas, parciales y las denominadas ausencias. La prevalencia de epilepsia activa se presenta aproximadamente en 5 – 10 personas por 1000 habitantes y una incidencia aproximada de 40–70 por cada 100.000 en los países industrializados y 100–190 por 100.000 en países de en vías de desarrollo. La base del tratamiento de la epilepsia son medicamentos anticonvulsivos iniciándose generalmente con mono terapia, sin embargo, hay un 30% de pacientes que no responde a ella, en este caso suele recurrirse a la asociación de dos o más fármacos antiepilépticos (FAE), recomendándose iniciar el tratamiento con biterapia. El presente estudio tuvo como objetivo evaluar la efectividad del tratamiento con dos Fármacos antiepilépticos en pacientes con poca respuesta a la mono terapia en el Hospital regional 2 IESS "Dr. Teodoro Maldonado Carbo" 2011 – 2012 al determinar la incidencia, combinación más efectiva y más frecuente de FAE, determinando los principales efectos indeseables y la relación del estado de mejoría al añadir nuevos antiepilépticos frente a los tradicionales mediante una investigación tipo descriptiva – correlacional, con un diseño no experimental, longitudinal - prospectivo. Se observó que el 73% de los pacientes presentó una mejoría en las crisis y la mejor combinación fue AVP + LMT (88,0±19,1%), seguida por CBZ +LMT (83,8±28,0%). El 44,4% de los pacientes tuvieron complicaciones, y el efecto indeseable más frecuente fue la somnolencia y los mareos.
Epilepsy is a cronic pathology characterized of repetitive paroxism that are produced by the suddenly, simultaneously, abnormal intense activation of a group of neurons. These paroxism are the epileptic seizures, with different clinical manifestations like generalized, partial, etc. The prevalence of Epilepsy around the world is about 5-10 per 1000 habitants, and an Incidence of approximately 40 – 70 per 100.000 people in high income countries and 100 – 190 per 100.00 people in low income countries. Almost all the patients with newly diagnosed epilepsy begin treatment with Antiepileptic Drugs (AEDs) in monotherapy, however, there is a 30% of patients that continue to have seizures despite adequate trials of a range of licensed drugs used singly or in combination, this individuals are regarded as having refractory epilepsy, in this case, the association of two or more antiepileptic drugs (AEDs), in a combinated treatment is the correct choose. The present study aims to evaluate the effectiveness of treatment with two AEDs in patients with poor response to monotherapy in the regional 2 IESS Hospital "Dr. Teodoro Maldonado Carbo" from 2011 to 2012 which will be determined by the incidence of this pathology, indicating the most effective combination of AEDs and the ones of more frequent use, determine the main effects and the intolerable side effects of improvement when adding new AEDs compared to traditional research through analytical type - descriptive, experimental design, retro - prospective, longitudinal patients treated for epilepsy with poor response to monotherapy. With the results of this research will recommend appropriate drug database management of these patients to decrease the crisis.
Epilepsy is a cronic pathology characterized of repetitive paroxism that are produced by the suddenly, simultaneously, abnormal intense activation of a group of neurons. These paroxism are the epileptic seizures, with different clinical manifestations like generalized, partial, etc. The prevalence of Epilepsy around the world is about 5-10 per 1000 habitants, and an Incidence of approximately 40 – 70 per 100.000 people in high income countries and 100 – 190 per 100.00 people in low income countries. Almost all the patients with newly diagnosed epilepsy begin treatment with Antiepileptic Drugs (AEDs) in monotherapy, however, there is a 30% of patients that continue to have seizures despite adequate trials of a range of licensed drugs used singly or in combination, this individuals are regarded as having refractory epilepsy, in this case, the association of two or more antiepileptic drugs (AEDs), in a combinated treatment is the correct choose. The present study aims to evaluate the effectiveness of treatment with two AEDs in patients with poor response to monotherapy in the regional 2 IESS Hospital "Dr. Teodoro Maldonado Carbo" from 2011 to 2012 which will be determined by the incidence of this pathology, indicating the most effective combination of AEDs and the ones of more frequent use, determine the main effects and the intolerable side effects of improvement when adding new AEDs compared to traditional research through analytical type - descriptive, experimental design, retro - prospective, longitudinal patients treated for epilepsy with poor response to monotherapy. With the results of this research will recommend appropriate drug database management of these patients to decrease the crisis.
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EPILEPSIA, FÁRMACOS, TRATAMIENTO TERAPÉUTICO, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, ANTICONVULSIVANTES, RESULTADO DEL TRATAMIENTO, EVALUACIÓN DE MEDICAMENTOS, CANTÓN GUAYAQUIL, ECUADOR