노인 입원환자에서의 항경련제 사용양상평가

Drug Utilization Review on Antiepileptic Drugs in Korean Elderly Inpatients

Objectives : This study was designed to review the Drug prescription pattern of anti epileptic drugs for elderly inpatients. Methods The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort(KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation(KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1994. The database included person머 identifier, age, sex, diagnosis, the name of drugs, dosage, the date of prescription and the code number of medical institution where the patients were admitted. The distribution of prescription by each antiepileptic drugs was analysed. Combined prescription of antiepileptic drugs and the possibility of drug interaction with antiepileptic drugs were also analysed. Results : The number of patients prescribed antiepileptic drugs was 208(5.6%) among elderly inpatients within KEPEC members. The most frequently prescribed antiepileptic drug was phenytoin(41.8%), followed by phenobarbital(19.8%) and carbamazepine(18.0%). The proprotion of combined prescription between antiepileptic drugs was 14.2%. Combination with phenytoin and valproic acid was most frequently prescribed. The rate of combined prescription of antiepileptic drugs and drugs that could induce risk from drug interaction with antiepileptic drugs was very high, phenytoin(86.2%), phenobarbital (80.0%), valproic acid(78.3%), respectively. That of carbamazepine(12.0%) was lower than other antiepileptic dugs. Conclusion : There were a lot of many comedications between antiepileptic drugs and several drugs with drug-interaction in this study. This situation was able to serious problem because antiepileptic drugs in elderly inpatients could induce adverse drug reactions and hazardous drug-drug interaction. This study proposes that antiepileptic drugs should be used carefully in the elderly.