ANUNG KUSTRIYANI, 051615153008 (2018) ANALISIS RASIO PDD/DDD PRODUK OBAT MONOTERAPI DAN POLITERAPI OBAT ANTI EPILEPSI (OAE) DENGAN FREKUENSI KEJANG PADA PASIEN EPILEPSI (Penelitian di Poliklinik Instalasi Rawat Jalan Neurologi RSUD Dr. Soetomo Surabaya). Thesis thesis, Universitas Airlangga.

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Abstract

Background : The aim of giving antiepileptic drugs (AEDs) is control of seizure. Many AEDs has a narrow therapeutic index. The efficacy of AEDs in seizure control can be obtained by giving a dose of AEDs in the therapeutic dose range. The dose of AEDs can be expressed as a PDD/DDD ratio. Some studies suggest that change in the frequency of seizure can be caused by switching of AEDs others than being influenced by other factors. Objective : The aim of this cohort observational study is analyzing ratio PDD/DDD and knowing switching antiepileptic drugs brands to seizure frequency in monotherapy and polytherapy patient with Epilepsy. Method : Seizure frequency were measured on routine patient visits to ambulatory care of neurology department. Sampling in this study were collected by consecutive sampling in cross sectional study. Medical records and pharmacy databases are collected from January 2017 to September 2018. Result : 128 patient with epilepsy were participated in this study. In PDD/DDD ratio study and switching AEDs, monotherapy and polytherapy AEDs were prescribed in 57 and 51 patients; 68 and 60 patients, respectively. Of them, monotherapy and polytherapy consist of 52.6% were female, 47.4% were male and 58.8% were female, 41.2% were male; 52.9% were female, 47.1% were male and 56.7% were female, 43.3% were male. Mean age in monotherapy and polytherapy were 36.72 ± 13.40 yr and 35.20 ± 11.43 yr; 36.15±12.84 yr and 35.35±11.61 yr. The biggest type of successive seizures in monotherapy and polytherapy is unknown seizure, generalized seizures, and focal seizures. Patients on monotherapy and polytherapy were in good control of seizures. AEDs frequently prescribed in monotherapy was Fenitoin, Carbamazepin, and Valproat. In polytherapy, AEDs frequently combine with Clobazam. The mean PDD/DDD ratio of AEDs significantly higher in polytherapy than monotherapy (p < 0,05). In the monotherapy and polytherapy group, AEDs substitution was 42.6% and 53.3%. Switching AEDs can cause a decrease in the frequency of seizures, an increase in the frequency of seizures, and no change in the frequency of seizures. In a comparative test analysis, there was no correlation between PDD/DDD ratio of AEDs and seizure frequency in monotherapy and polytherapy (p > 0.05). Conclusion : AEDs first generation frequently prescribed di Soetomo Hospital. Switching AEDs can cause decrease, increase, and no change in the frequency of seizures. There is no correlation between PDD/DDD ratio in the group of anti-epilepsy monotherapy and polytherapy drugs with seizure frequency (p > 0,05).

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