Tratamento medicamentoso da epilepsia em gestantes e em outas comorbilidades: contribuiçaõa para uso racional de medicamentos

Abstract

Epilepsy is a chronic neurological disease that when accompanied by other pathophysiological may require adjustments in drug treatment. In pregnancy, anticonvulsants may present a risk to maternal and fetal body. On the other hand, pregnancy can affect the concentrations of anticonvulsants, changing the occurrence of crises. Is estimated that 26.8 the 84% of patients with epilepsy have at least one comorbidity. Review of pharmacological, clinical aspects and drug interactions for the treatment of epilepsy in comorbidity with psychiatric disorders, cardiovascular diseases, liver diseases and kidney diseases and in pregnancy, held in the databases Medline/PubMed; Cochrane and google scholar, restricting to articles free text in humans between 2006 and 2017 . The valproate presents the greatest risks of congenital malformation during pregnancy and your use must be avoided. The concentrations of Lamotrigine 40-60% decrease during gestation, relating to increased seizures in 58% of pregnant women. Renal and hepatic diseases mainly affect the prescription regimen of anticonvulsants and the choice of these drugs. Anticonvulsants affect differently the psychiatric disorders, by contrast, antidepressants, demonstrate low risk of causing seizures, while antipsychotics, mainly clozapine demonstrate increased risk. Lamotrigine and leviteracetam has been associated with lower cardiovascular risk. Carbamazepine Phenobarbital, Phenytoin and valproate are involved in clinically important drug interactions. The treatment of people with epilepsy should take into consideration beyond the efficacy of anticonvulsants in epilepsy, the influence of these on other health situations and of these On the treatment of epilepsy, promoting the rational use of drugs.