Strategi pengobatan epilepsi: monoterapi dan politerapi
https://doi.org/10.22146/bns.v18i3.55017 Atitya Fithri Khairani(1*), Desin Pambudi Sejahtera(2), Iqbal Amri Fauzal(3)
(1) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Dokter internship Rumah Sakit Islam Yogyakarta (PDHI)
(*) Corresponding Author
Abstract
Epilepsi merupakan penyakit yang sering dijumpai, pada bangkitan yang tidak diobati akan meningkatkan risiko cedera dan kematian, kelainan kognitif dan perilaku serta kerugian sosial. Target jangka pendek pengobatan epilepsi adalah bebas bangkitan. Prinsip manajemen terapi untuk pasien dengan epilepsi yang baru didiagnosis adalah monoterapi. Sebagian kasus epilepsi belum terkontrol baik dengan pemberian monoterapi Obat Anti Epilepsi (OAE) sehingga politerapi menjadi strategi pengobatan selanjutnya. Belum banyak bukti yang kuat sebagai acuan dokter tentang kapan dan bagaimana mengkombinasikan OAE. Pada artikel ini kami menjelaskan pertimbangan cara memilih OAE, kapan dan bagaimana pengobatan politerapi OAE kombinasi dapat dilakukan.
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1.Sander JW. The epidemiology of epilepsy revisited. Current opinion in neurology. 2003;16(2):165-170.
2.Kwan P, Brodie MJ. Early identification of refractory epilepsy. New England Journal of Medicine. 2000;342(5):314-319.
3.Mohanraj R, Brodie MJ. Pharmacological outcomes in newly diagnosed epilepsy. Epilepsy & Behavior. 2005;6(3):382-387.
4.Loscher W, Schmidt D. Modern antiepileptic drug development has failed to deliver: ways out of the current dilemma. Epilepsia. 2011; 52:657–678.
5.Schmidt DI. Reduction of two-drug therapy in intractable epilepsy. Epilepsia. 1983;24:368–376.
6.Schmidt DI. Two antiepileptic drugs for intractable epilepsy with complex-partial seizures. Journal of Neurology, Neurosurgery & Psychiatry. 1982;45(12):1119-1124.
7.PROGRESS Collaborative Group. Randomised trial of perindnopril-based blood pressure lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358:1033-41.
8.Beghi E, Gatti G, Tonini C, et al. Adjunctive therapy versus alternative monotherapy in patients with partial epilepsy failing on a single drug: a multicentre, randomised, pragmatic controlled trial. Epilepsy Res. 2003;57:1–13.
9.Kwan P, Brodie MJ. Epilepsy after the first drug fails: substitution or add-on? Seizure. 2000;9:464–468.
10.Beghi E, Perucca E. The management of epilepsy in the 1990s. Drugs. 1995;49(5):680-694.
11.Brodie MJ, Mumford JP. Double-blind substitution of vigabatrin and valproate in carbamazepine-resistant partial epilepsy. Epilepsy research. 1999;34(2-3):199-205.
12.Reynolds E, Shorvon S, Bauer G. Monotherapy or Polytherapy or Epilepsy. Wien Klin Wochenschr. 1984;96(15):566-568.
13.Deckers C. Overtreatment in adults with epilepsy. Epilepsy Res. 2002; 52: 43-52.
14.Mohanraj R, Brodie MJ. Outcomes in newly diagnosed localisation-related epilepsies. Seizure. 2005; 14: 318-23.
15.Kwan P, Brodie MJ. Drug treatment of epilepsy: when does it fail and how to optimize its use?. CNS spectrums. 2004;9(2):110-119.
16.Perucca E, Kwan P. Overtreatment in epilepsy: how it occurs and how it can be avoided. CNS drugs. 2005;19(11):897-908.
17.Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001;42(10):1255-1260.
18.Brodie MJ, Kwan P. The “star” systems: overview and use in determining drug choice for patients with epilepsy. CNS Drugs. 2001;18:1-2.
19.Louis EK, Gidal BE, Henry TR, Kaydanova Y, Krumholz A, McCabe PH, Montouris GD, Rosenfeld WE, Smith BJ, Stern JM, Waterhouse EJ. Conversions between monotherapies in epilepsy: expert consensus. Epilepsy & Behavior. 2007;11(2):222-234.
20.Kusumastuti K, Gunadarma S. Pedoman Tatalaksana Epilepsi. Kelompok Studi Epilepsi PERDOSSI. Surabaya. 2014:1-68.
21.Schmidt DI, Elger C, Holmes GL. Pharmacological overtreatment in epilepsy: mechanisms and management. Epilepsy research. 2002;52(1):3-14.
22.Sisodiya SM. Genetics of drug resistance. Epilepsia. 2005;46:33-38.
23.Kwan P, Brodie MJ. Combination therapy in epilepsy. Drugs. 2006;66(14):1817-1829.
24.Deckers CL, Hekster YA, Keyser A, Meinardi H, Renier WO. Reappraisal of polytherapy in epilepsy: a critical review of drug load and adverse effects. Epilepsia. 1997;38(5):570-575.
25.Brodie MJ, Sills GJ. Combining antiepileptic drugs—rational polytherapy?. Seizure. 2011;20(5):369-375.
26.French JA, Gidal BE. Antiepileptic drug interactions. Epilepsia. 2000;41:S30-36.
27.Brodie MJ, Yuen AW, Group S. Lamotrigine substitution study: evidence for synergism with sodium valproate?. Epilepsy research. 1997;26(3):423-432.
28.Besag FM, Berry DJ, Pool F, Newbery JJ, Subel B. Carbamazepine toxicity with lamotrigine: pharmacokinetic or pharmacodynamic interaction?. Epilepsia. 1998;39(2):183-187.
29.Mani J. Combination therapy in epilepsy: what, when, how and what not. J Assoc Physicians India. 2013;61(8 Suppl):40.
30.French JA, Faught E. Rational polytherapy. Epilepsia. 2009;50:63-68. 31.Rowan AJ, Meijer JW, de Beer-Pawlikowski N, van der Geest P, Meinardi H. Valproate-ethosuximide combination therapy for refractory absence seizures. Archives of neurology. 1983;40(13):797-802. 32.Leach JP, Brodie M. Synergism with GABAergic drugs in refractory epilepsy. Lancet (London, England). 1994;343(8913):1650.
DOI: https://doi.org/10.22146/bns.v18i3.55017
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