| Seizure management in a complex hospice patient. | |
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MedLine Citation:
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PMID: 20345197 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Antiepileptic medication use in noncancer hospice/palliative care patients is not well defined. The authors report the case of a human immunodeficiency virus (HIV) patient under hospice care with increased seizure frequency. The patient is a 22-year-old female with advanced HIV disease complicated by tonic-clonic seizures, hypoalbuminemia, gastroesophageal reflux disease (GERD), and gastritis. During an admission to the hospice inpatient unit, she developed increasing seizure frequency while receiving oral phenytoin. After collaboration between the clinical pharmacist and the hospice treating physician, they simplified her medication regimen, discontinued the phenytoin, and initiated oral levetiracetam. After these adjustments to her medication regimen, the patient's seizure frequency decreased significantly. This case illustrates the challenges of anticonvulsant use in advanced disease, including drug-drug interactions, impaired pharmacokinetics parameters, and increased risk of adverse effects. The importance of continuously monitoring patients for adverse drug events and assessing patient specific factors to help guide medication selection are also highlighted. |
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Authors:
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Katherine M Juba; David Weiland |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of pain & palliative care pharmacotherapy Volume: 24 ISSN: 1536-0539 ISO Abbreviation: J Pain Palliat Care Pharmacother Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-29 Completed Date: 2010-06-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101125608 Medline TA: J Pain Palliat Care Pharmacother Country: England |
Other Details:
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Languages: eng Pagination: 27-32 Citation Subset: IM |
Affiliation:
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Bayfront Medical Center, St. Petersburg, Florida, USA. kjuba@sjfc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Retroviral Agents
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therapeutic use Anticonvulsants / therapeutic use* Drug Interactions Female HIV Infections / complications, drug therapy* Hospice Care / methods* Humans Piracetam / analogs & derivatives*, therapeutic use Seizures / complications, drug therapy* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anti-Retroviral Agents; 0/Anticonvulsants; 33996-58-6/etiracetam; 7491-74-9/Piracetam |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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