소아에서 Oxcarbazepine과 Carbamazepine에 의한 저나트륨혈증
Hyponatremia in Childhood Patients with Oxcarbazepine and Carbamazepine
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose : Long term oral medications of anticonvulsants are inevitable in pediatric epilepsy patients. Therefore special attention is needed for the complications caused by these medications. Hyponatremia is a well known complication of carbamazepine(CBZ) and oxcarbazepine(OXC), but researches in pediatric patients are rare. This is a study about the development of hyponatremia during the use of these two anticonvulsants in pediatric epilepsy patients and other factors also involved in it. Methods : We studied serum sodium levels of 267 pediatric patients who were treated with either CBZ or OXC in our hospital from January 2003 to December 2006. Hyponatremia was defined as Na＋<138 mEq. Moderate hyponatremia was defined as Na＋<130 mEq. Factors thought to be involved in the development of hyponatremia were studied also. These included age, sex, EEG and radiologic test results, use of any other medications, etc. Results : Among the 267 pediatric patients treated with CBZ or OXC, there were 18 cases (6.7%) of moderate hyponatremia and 28 cases(10.5%) of mild hyponatremia. Sex, age, type of seizure, EEG and radiologic test results did not affect the development of hyponatremia. But combination therapy with other anticonvulsants resulted in an increase of hyponatremia. Conclusion : We recommend that serum sodium levels should be checked regularly of the pediatric patients taking CBZ or OXC, especially patients treated with additional drugs (combination therapy).
Abstract
Purpose : Long term oral medications of anticonvulsants are inevitable in pediatric epilepsy patients. Therefore special attention is needed for the complications caused by these medications. Hyponatremia is a well known complication of carbamazepine(CBZ) and oxcarbazepine(OXC), but researches in pediatric patients are rare. This is a study about the development of hyponatremia during the use of these two anticonvulsants in pediatric epilepsy patients and other factors also involved in it. Methods : We studied serum sodium levels of 267 pediatric patients who were treated with either CBZ or OXC in our hospital from January 2003 to December 2006. Hyponatremia was defined as Na＋<138 mEq. Moderate hyponatremia was defined as Na＋<130 mEq. Factors thought to be involved in the development of hyponatremia were studied also. These included age, sex, EEG and radiologic test results, use of any other medications, etc. Results : Among the 267 pediatric patients treated with CBZ or OXC, there were 18 cases (6.7%) of moderate hyponatremia and 28 cases(10.5%) of mild hyponatremia. Sex, age, type of seizure, EEG and radiologic test results did not affect the development of hyponatremia. But combination therapy with other anticonvulsants resulted in an increase of hyponatremia. Conclusion : We recommend that serum sodium levels should be checked regularly of the pediatric patients taking CBZ or OXC, especially patients treated with additional drugs (combination therapy).
참고문헌 (22)
- Borusiak P., "Hyponatremia induced by oxcarbazepine in children", Epilepsy Res, 30, pp.241~246 (1998)
- Kelly B.D., "Hyponatremia during carbamazepine therapy in patients with intellectual disability", J Intellect Disabil Res, 45, pp.152~156 (2001)
- Kalff R., "Carbamazepine and serum sodium levels", Epilepsia, 25, pp.390~397 (1984)
- Johannessen A.C., "Hyponatremia induced by oxcarbazepine", Epilepsy Res, 1, pp.155~156 (1987)
- Serdaroglu G., "Oxcarbazepine in the treatment of childhood epilepsy", Pediatr Neurol, 28, pp.37~41 (2003)
- Friis M.L., "Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment", Acta Neurol Scand, 87, pp.224~227 (1993)
- Dong X., "Hyponatremia from oxcarbazepine and carbamazepine", Neurology, 65, pp.1976~1978 (2005)
- Behrman R.E., "Nelson. Textbook of pediatrics", pp.196~2208 (2000)
- Belopitova L., "Comparative study on the effect of oxcarbazepine and carbamazepine in childhood epilepsies", European Jounal of pediatric Neurology, 3, pp.25~ (1999)
- Kuz G.M., "Carbamazepine-induced hyponatremia: Assessment of risk factor", Ann Pharmacother, 39, pp.1943~1946 (2005)
- Rambeck B., "Valproic acid-induced carbamazepine-10,11-epoxide toxicity in children and adolescents", Eur Neurol, 30, pp.79~83 (1990)
- O'Hare J., "Hyponatremia and carbamazepine intoxication", Ir J Med Sci, 149, pp.10~14 (1980)
- Koivikko M.J., "Hyponatremia during carbamazepine therapy in children", Neuropediatrics, 14, pp.93~96 (1983)
- Bourgeois B.F., "Long-term safety and tolerability of oxcarbazepine in children", Epilepsy Behav, pp.375~382 (2005)
- Schmidt D., "Recommendaions on the clinical use of oxcarbazepine in the treatment of epilepsy: a consensus view", Acta Neurol Scand, 104, pp.167~170 (2001)
- Pendlebury S.C., "Hyponatremia during oxcarbazepine therapy", Hum Toxicol, 8, pp.337~344 (1989)
- Van Amelsvoort T., "Hyponatremia associated with carbamazepine and oxcarbazepine therapy : a review", Epilepsia, 35, pp.181~188 (1994)
- Kloster R., "Sudden death in two patients with epilepsy and the syndrome of inappropriate antidiuretic hormone secretion(SIADH)", Seizure, 7, pp.419~420 (1998)
- Fisher R., "Oxcarbazepine, Tiagabine, Topiramate, and other new antiepileptic drugs", Epilepsia, pp.105~114 (1995)
- Lahr M.B., "Hyponatremia during carbamazepine therapy", Clin Pharmacol Ther, 37, pp.693~696 (1985)
- Reinikainen K.J., "Comparison of oxcarbazepine and carbamazepine: a double blind study", Epilepsy Res, 1, pp.284~289 (1987)
- Tebb Z., "New anticonvulsants, New adverse effects", South Med J, 99, pp.375~279 (2006)