Page 153 - ITPS-7-2

INNOSC Theranostics and
Pharmacological Sciences From fever to seizure: A pediatric case study

imbalances, common in febrile illnesses and seizures. The FSE, where precise medication management is critical,
treatment regimen aimed at controlling seizures, managing underscores the pivotal role of clinical pharmacists in
infection, and providing symptomatic relief, aligning with ensuring safe and effective pharmacotherapy. Their
established protocols for FSE management. involvement significantly contributes to improved patient
The dynamic nature of the patient’s symptoms outcomes and reduced likelihood of medication-related
throughout the hospital stay underscores the importance of complications, highlighting their indispensable role in
closely monitoring these cases. Adjustments in medication pediatric care. FSE poses a serious health concern in pediatric
were crucial in mitigating fever spikes, controlling seizures, patients, necessitating prompt recognition, appropriate
7-9
and reducing associated symptoms. The normalization of interventions, and meticulous monitoring. This case
laboratory parameters and the resolution of clinical signs report emphasizes the challenges encountered in managing
contributed to the decision for discharge. However, the FSE, ranging from diagnosis to treatment modifications.
case also revealed potential drug interactions, particularly Tailored therapeutic strategies, vigilant monitoring, and an
with carbapenems, emphasizing the need for careful understanding of potential drug interactions are pivotal for
consideration of medication choices, especially in patients achieving favorable outcomes in such cases.
predisposed to seizures or neurological complications. The evaluation and management of febrile seizures in
This underscores the significance of a multidisciplinary children involve a nuanced approach to determine the
approach involving pediatricians, neurologists, and underlying cause and ensure appropriate interventions. 1,13
pharmacists in optimizing treatment strategies.
3.1. Diagnostic investigations
In cases of FSE involving pediatric patients, the role of
clinical pharmacists is indispensable in optimizing medication The two sources highlight varying recommendations for
regimens and ensuring treatment effectiveness while mitigating diagnostic investigations in the context of febrile seizures.
potential risks associated with drug interactions. These The first source discourages routine tests such as full blood
professionals conduct comprehensive medication reviews, count, electrolytes, and glucose levels unless clinically
critically evaluating prescribed drugs, including antibiotics, indicated, emphasizing that these parameters do not alter
anticonvulsants, and supportive care medications, to prevent the management course of febrile seizures. In contrast,
adverse reactions and enhance therapeutic outcomes. the second source presents a more detailed approach,
4-6
Clinical pharmacists provide valuable insights into dosing suggesting lumbar puncture in specific scenarios, especially
regimens, aligning medications with the patient’s age and for young infants and cases with suspected meningitis. 14-16
weight and suggesting alternative therapies to minimize drug 3.2. Neuroimaging and EEGs
interactions and potential complications. The complex nature
of administering multiple medications, especially in critical The recommendations on neuroimaging and EEGs
scenarios like FSE, heightens the risk of drug interactions, also differ. The first source advocates against routine
particularly with compounds such as carbapenems. Clinical neuroimaging for febrile seizures, suggesting it is rarely
pharmacists excel in identifying potential interactions and needed for simple cases. 13,17 On the other hand, the second
guiding necessary adjustments or alternate medication options. source acknowledges specific situations where neuroimaging
Their vigilance extends to actively monitoring patients for and EEG might be considered, especially for children with
signs of adverse reactions or drug interactions throughout the recurrent or complex febrile seizures. 18,19
treatment trajectory, ensuring timely intervention to prevent 3.3. Treatment and prevention
complications. Education and counseling are fundamental
aspects of a clinical pharmacist’s role. They educate caregivers Both sources discuss the use of benzodiazepines for
about medication usage, potential side effects, and the seizures, but the second source provides a more nuanced
significance of adhering to the treatment plan. In cases like FSE, perspective on their efficacy in febrile seizures. It
where managing seizures and fever is paramount, pharmacist- emphasizes the uncertain efficacy of benzodiazepines in
led guidance empowers caregivers to recognize warning febrile seizures while acknowledging their accepted use
signs, respond during emergency seizures, and adhere strictly in FSE. 20-22 In addition, the second source introduces the
to the prescribed medication regimen. The collaborative consideration of antipyretics and their limited impact on
efforts of clinical pharmacists within the healthcare team, febrile seizure recurrence. 22,23
involving pediatricians, neurologists, and other specialists,
are instrumental. They contribute invaluable perspectives in 3.4. Evaluation
multidisciplinary discussions, aligning therapeutic plans with The second source introduces the concept of “red flags” for
the patient’s clinical condition to minimize adverse events and febrile seizures, emphasizing specific signs that warrant
optimize treatment strategies. further evaluation, such as complex febrile seizures,

Volume 7 Issue 2 (2024) 4 doi: 10.36922/itps.2735