Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-17T16:06:24.693Z Has data issue: false hasContentIssue false
  • English
  • Français

The Carbohydrate and Caloric Content of Concomitant Medications for Children with Epilepsy on the Ketogenic Diet

Published online by Cambridge University Press:  02 December 2014

Denis Lebel ,
Caroline Morin ,
Nathalie Achim ,
Micheline Laberge  and
Lionel Carmant
Denis Lebel
Affiliation:
Department of Pharmacy, Hôpital Ste-Justine, University of Montreal, Montreal, QC Canada
Caroline Morin
Affiliation:
Department of Pharmacy, Hôpital Ste-Justine, University of Montreal, Montreal, QC Canada
Nathalie Achim
Affiliation:
Department of Pharmacy, Hôpital Ste-Justine, University of Montreal, Montreal, QC Canada
Micheline Laberge
Affiliation:
Department of Pediatrics, Hôpital Ste-Justine, University of Montreal, Montreal, QC Canada
Lionel Carmant
Affiliation:
Department of Pediatrics, Hôpital Ste-Justine, University of Montreal, Montreal, QC Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

The ketogenic diet for children with refractory epilepsy requires a strict control of the amount of ingested carbohydrates. This can be altered by medication prescribed for the epileptic syndrome or for intercurrent illnesses. The goal of this paper is to compile the carbohydrate and caloric content of commonly used medications in this population.

Methods:

We compiled a list of frequently used medications with the help of Canadian manufacturers and the Compendium of Pharmaceuticals and Specialties. We also tested a worst case scenario calculation based on the weight of the tablet.

Results:

We list the carbohydrate and caloric content of 790 medications studied. Our worst case scenario gives an over-estimate in all cases, making adjustments based on this calculation in an emergency setting safe.

Conclusion:

We propose this list as a tool for physicians, dietitians, nurses and pharmacists. The list can easily be adjusted, based on local practices and reviewed periodically.

Résumé:

RÉSUMÉ:

Le contenu en hydrates de carbone et en calories des médicaments concomitants chez les enfants épileptiques suivant la diète cétogène.

Introduction:

La diète cétogène chez les enfants dont l'épilepsie est résistante au traitement demande un contrôle strict de la quantité d'hydrates de carbone ingérée qui peut être influencée par la médication prescrite pour le syndrome épileptique ou pour une maladie intercurrente. Le but de cet article est de compiler le contenu en hydrates de carbone et en calories de médicaments d'usage courant dans cette population.

Méthodes:

Nous avons compilé une liste des médicaments d'usage courant avec l'aide de manufacturiers Canadiens et du Compendium des produits et spécialités pharmaceutiques. Nous avons également testé un calcul basé sur le poids du comprimé qui tenait compte de la pire situation possible.

Résultats:

Nous avons dressé une liste du contenu en hydrates de carbone et en calories de 790 médicaments. Notre calcul selon la pire situation surestime dans tous les cas, ce qui assure la sécurité de l'ajustement basé sur ce calcul en situation d'urgence.

Conclusions:

Nous proposons cette liste comme outil pour les médecins, les diététistes, les infirmières et les pharmaciens. La liste peut facilement être ajustée selon les pratiques locales et révisée périodiquement.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 4 , November 2001 , pp. 322 - 340
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

1. Freeman, JM, Vining, EP, Pillas, DJ, et al. The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics 1998;102:1358–1363.CrossRefGoogle ScholarPubMed
2. Barboka, CJ. Epilepsy in adults: results of treatment by ketogenic diet in one hundred cases. Arch Neurol Psychiatr 1930;23:904–914.Google Scholar
3. Guelpa, G, Marie, A. La lutte contre l’épilepsie par la désintoxication et par la rééducation alimentaire. Revue de Thérapie Medico-Chirurgicale 1911;78:8–13.Google Scholar
4. Wilder, RM. The effect of ketonemia on the course of epilepsy. Mayo Clin Bull 1921;2:(307);314.Google Scholar
5. Livingston, SL. Comprehensive Management of Epilepsy in Infants, Childhood and Adolescence. Springfield, IL: Charles C Thomas. 1972:378–405.Google Scholar
6. Wheless, JW. The ketogenic diet: fact or fiction. J Child Neurol 1995;10:419–423.Google Scholar
7. Huttenlocher, PR. Ketonemia and seizures: metabolic and anti-convulsant effects of two ketogenic diets in childhood epilepsy. Pediatr Res 1976;10(5):536–540.Google Scholar
8. Bough, KJ, Matthews, PJ, Eagles, DA. A ketogenic diet has different effects upon seizures induced by maximal electroshock and by pentylenetetrazol infusion. Epilepsy Res 2000;38:105–114.Google Scholar
9. Thio, LL, Wong, M, Yamada, KA. Ketone bodies do not directly alter excitatory or inhibitory hippocampal synaptic transmission. Neurology 2000;54:325–331.Google Scholar
10. Feldstein, TJ. Carbohydrate and alcohol content of 200 oral liquid medications for use in patients receiving ketogenic diets. Pediatrics 1996;97:506–511.Google Scholar
11. Tallian, KB, Nahata, MC, Tsao, CY. Role of the ketogenic diet with intractable seizures. Ann Pharmacother 1998;32:349–361.CrossRefGoogle ScholarPubMed
12. McGarry, JD. Glucose-fatty acid interactions in health and disease. Am J Clin Nutr 1998;67(Suppl):500S–504S.CrossRefGoogle ScholarPubMed
13. Li, J, Norwood, DL, Mao, LF, Schulz, H. Mitochondrial metabolism of valproic acid. Biochemistry 1991;30:388–394.Google Scholar
14. Bjorge, SM, Baillie, TA. Inhibition of medium-chain fatty acid beta-oxidation in vitro by valproic acid and its unsaturated metabolite, 2-n-propyl-4-pentenoic acid. Biochem Biophys Res Commun 1985;132:245–252.Google Scholar
15. Ballaban-Gil, K, Callahan, C, O’Dell, C, et al. Complications of the ketogenic diet. Epilepsia 1998;39:744–748.Google Scholar
16. Kinsman, SL, Vining, EPG, Quakey, SA, Mellitis, D, Freeman, JM. Efficacy of the ketogenic diet for intractable seizure disorders: review of 58 cases. Epilepsia 1992;33:1132–1136.CrossRefGoogle ScholarPubMed
17. Kizer, JS, Vargas-Gordon, M, Brendel, K, Bressler, R. The in vitro inhibition of insulin secretion by diphenylhydantoin. J Clin Invest 1970;49:1942–1948.CrossRefGoogle ScholarPubMed
18. Boquist, L, Backman, AM, Stromberg, C. Hyperglycemia produced in mice by administration of acetazolamide and diphenylhydantoin. Eur J Pharmacol 1980;64:325–332.Google Scholar
19. Venkatesan, N, Davidson, MB, Simsolo, RB, Kern, PA. Phenobarbital treatment enhances insulin-mediated glucose metabolism and improves lipid metabolism in the diabetic rat. Metabolism 1994;43:348–356.CrossRefGoogle ScholarPubMed
20. Karam, JH. Reversible insulin resistance in noninsulin-dependent diabetes mellitus. Horm Metab Res 1996;28:440–444.Google Scholar