Team develops database to warn physicians of possible drug interactions for epilepsy patients on ketogenic diets

February 9, 2018, University of Arizona

A physician-scientist at the University of Arizona College of Medicine - Phoenix has developed a new database to ensure that individuals on ketogenic diets to help treat a certain kind of epilepsy are not prescribed potentially life-threatening medications that contain carbohydrates.

Working in partnership with Phoenix Children's Hospital, Andrew Muth, MD, a UA clinical informatics fellow, has developed a database to alert physicians about the carbohydrate count in medications so they do not prescribe high-carbohydrate medications to with epilepsy on ketogenic diets for health concerns. His primary focus is to improve treatment options for children with "refractory epilepsy," or seizures that have not been controlled with medications. The built-in clinical support tool is unique to Phoenix Children's Hospital, Dr. Muth said.

"I wanted to prevent patients with epilepsy on ketogenic diets from unintentionally being exposed to carbohydrates," Dr. Muth said. "There have been cases where such patients have accidentally been prescribed intravenous fluids that contain dextrose and had adverse outcomes, including breakthrough seizures and status epilepticus."

(In a breakthrough seizure, an individual who has been on a stable regimen of anti-epileptic drugs has a seizure; status epilepticus is a dangerous condition where seizures follow one another without recovery of consciousness between them.)

Dr. Muth worked with a multi-disciplinary team at Phoenix Children's Hospital, including: Mary Babico, PharmD; Lisa Vanatta, MS, RDN, CSP; and Melinda Loya, MSN, RN. The group worked under the supervision of Vinay Vaidya, MD, chief medical information officer at Phoenix Children's Hospital.

Out of a formulary of about 2,600 medications, the team identified 72 that never should be ordered for someone with epilepsy on a ketogenic diet.

About one-third of newly treated patients with have the refractory type, which impacts all ages, but the initial diagnosis and treatment often occurs in childhood when seizures first appear.

Patients follow a as one treatment option. The diet causes the body to make ketones, which are chemicals made from the breakdown of body fat. In many cases, higher ketone levels lead to improved control, Dr. Muth said.

"Our team came up with the idea for the project after an adverse event involving a child going into status epilepticus after taking a prescribed medication containing sugar," Dr. Muth said. "We knew we could prevent events like this from happening with the right database in place."

Developing the database was Dr. Muth's "quality improvement project" at the UA College of Medicine - Phoenix, where he is a second-year clinical informatics fellow. Clinical informatics fellows work on multiple projects throughout their two-year fellowship. The program's goal is to develop experts adept at integrating people, processes and platforms to improve the quality, safety and efficiency of health care.

"With informatics, you can treat multiple patients at a time, versus just the patient in front of you," Dr. Muth said. "You can impact an entire population of patients, plus you are able to impact and improve the workflow for clinicians."

"Using data and technology to protect and create better care scenarios for our patients is paramount and something we are very proud of here at Phoenix Children's Hospital," Dr. Vaidya said. "This effort also further solidifies our renowned Barrow Neurological Institute at Phoenix Children's Hospital Comprehensive Pediatric Epilepsy Program and our Level 4 National Association of Epilepsy Centers' accreditation."

Explore further: Diet may help fight epilepsy when meds fail

Related Stories

Diet may help fight epilepsy when meds fail

December 5, 2017
(HealthDay)—For children with epilepsy who don't find relief from their seizures with medication, a tightly controlled nutrition plan might help, a pair of new studies suggests.

Ketogenic diet shown safe and effective option for some with rare and severest form of epilepsy

February 27, 2017
In a small phase I and II clinical trial, Johns Hopkins researchers and colleagues elsewhere found that the high-fat, low-carbohydrate ketogenic diet was a safe and effective treatment option for the majority of adults experiencing ...

Low-carb, high-fat diets may reduce seizures in tough-to-treat epilepsy

October 29, 2014
Diets high in fat and low in carbohydrates, such as the ketogenic or modified Atkins diet, may reduce seizures in adults with tough-to-treat epilepsy, according to a review of the research published in the October 29, 2014, ...

Seizure study sheds light on lasting brain effects in children

December 6, 2017
Prolonged convulsive seizures in childhood could be linked to the development of other brain conditions, a study suggests.

UC Davis investigational medication used to resolve life-threatening seizures in children

November 12, 2014
In its first clinical application in pediatric patients, an investigational medication developed and manufactured at UC Davis has been found to effectively treat children with life-threatening and difficult-to-control epileptic ...

Free 'Track it!' app tracks seizures on Apple Watch

November 29, 2016
Nationwide Children's Hospital and SeizureTracker.com are introducing a new wearable app to help track seizures called Track It! – available for the Apple Watch in the Apple Store today.

Recommended for you

Researchers unravel why people with HIV suffer from more neurologic diseases

August 20, 2018
Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), which the HIV virus can cause, continue to be one of the world's greatest health problems.

Fluidically linked blood-brain barrier and Organ Chips offer new method for studying effects of drugs on the brain

August 20, 2018
The human brain, with its 100 billion neurons that control every thought, word, and action, is the most complex and delicate organ in the body. Because it needs extra protection from toxins and other harmful substances, the ...

Female mice are immune to cognitive damage from space radiation

August 20, 2018
Humankind still dreams of breaking from the bounds of Earth's atmosphere and venturing to the moon, Mars and beyond. But once astronauts blast past the International Space Station, they become exposed to one of the many dangers ...

Children with brain tumors who undergo radiation less likely to recall recent events

August 20, 2018
Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pre-treatment happenings, according to a Baylor ...

Rogue proteins may underlie some ALS and frontotemporal dementia cases, says study

August 20, 2018
ALS—amyotrophic lateral sclerosis—is a neurodegenerative disease that attacks motor neurons in the brain and spinal cord, slowly robbing its victims of their ability to walk, talk, breathe and swallow. In a cruel twist, ...

Bilingual children who speak native language at home have higher intelligence

August 20, 2018
Children who regularly use their native language at home while growing up in a different country have higher IQs, a new study has shown.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.