Jerome Engel, Jr., MD, PhD
Jonathan Sinay Distinguished Professor of Neurology, Neurobiology, and Psychiatry and Biobehavioral Sciences
Director, UCLA Seizure Disorder Center
David Geffen School of Medicine at UCLA
Los Angeles, California
William Garnett, PharmD
Professor of Pharmacy and Neurology
Virginia Commonwealth University
Medical College of Virginia
THIS PROGRAM WAS ORIGINALLY PRESENTED AS A LIVE AUDIOCONFERENCE BEGINNING ON MARCH 11, 2008. IF YOU RECEIVED CREDIT FOR PARTICIPATING IN THE AUDIOCONFERENCE, YOU ARE NOT ELIGIBLE TO RECEIVE CREDIT FOR THIS ONLINE ACTIVITY.
Epilepsy in the elderly is much more common than once thought. Research shows that the incidence of epilepsy in people age 75 and over is higher than in the first ten years of life. In fact, up to 50 percent of new seizures occur in people over the age of 65 years. It is likely that the preponderance of new-onset epilepsy in the elderly is a consequence ofthe increasing numbers of elderly in the population. This problem is likely to increase as lifespan increases. Seniors are especially prone to seizure disorders because of their risk for stroke, dementia, and metabolic disturbances.
Senior care pharmacists and nurses, particularly those working in assisted living and long-term care facilities, all play a vital role in the management of epilepsy in the elderly. These busy practitioners need to know how to recognize the clinical manifestations of epilepsy specific to the elderly and understand how to design and administer appropriate and personalized care plans for residents diagnosed with epilepsy.
A long and growing list of antiepileptic drugs (AEDs) remain the mainstay of pharmacotherapy for epilepsy. In the elderly, however, the mechanisms of these agents must be carefully considered. Providers must consider risk vs. benefit in the management of seizures, as well as drug-drug interactions, and other issues specific to the elderly, such as physiologic changes inherent in aging. Providers must understand the proper use of these agents, and the implications of adjusting dosing or switching from one AED to another. Educating providers on emerging data will help them to make informed decisions that are evidence-based and current, and help lessen the burden imposed on seniors by epilepsy.
. Target Audience
This program has been developed specifically for pharmacists, nursing directors, and nurses who care for patients in an eldercare setting.
Upon completion of this educational activity, the participant should be able to:
Describe the causes of epilepsy and seizures in the elderly, and recognize the warning signs specific to this population
Discuss the pharmacologic use of antiepileptic drug therapy as it relates to elderly residents with multiple comorbidities
Describe ways to reduce drug-drug interactions and adverse effects when prescribing AED therapy in an eldercare setting
Compare the potential benefits and harms of treatment discontinuation and outline appropriate ways to reduce or discontinue AED therapy in those who have been seizure free
It is the policy of ASCP, in accordance with the guidelines set forth by the Accreditation Council for Pharmacy Education, and NADONA to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by ASCP and NADONA prior to accreditation of the activity.
The intent of this disclosure is not to prevent a presenter with significant financial interest or other relationship from making the presentation, but rather to provide the audience with information with which they can make their own judgments. It remains for the audience to determine whether the speakers’ interests or relationships may influence the presentation with regard to exposition or conclusion. Faculty are also expected to openly disclose any off-label, experimental, or investigational use of drugs or devices in their presentations.
Dr. Engel discloses that he has served as a consultant for Dainippon Pharmaceutical Co., Ltd., and has received other financial or material support from Ortho McNeil, Inc. and UCB.
Dr. Garnett discloses that he has received research support from Ovation Pharmaceuticals, Inc., and has served as amember of the speakers' bureau for Abbott Laboratories and UCB.
This educational activity may contain discussion of published and/or investigational uses of pharmaceutical agents. Some uses of these agents may not have been approved by the FDA. Please refer to the official prescribing information for each project for discussion of approved indications, contraindications, and warnings. Credit Statements
The American Society of Consultant Pharmacists (ASCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program (ACPE # 203-999-08-002-H01-P) was developed by ASCP and is approved for 1.0 Contact Hour (0.1 CEU).
NADONA/LTC is an approved provider of continuing nursing education by Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation #1087. This program provides 1 contact hour by NADONA/LTC.
Participants must successfully complete the online post test (70% or higher) and submit an evaluation to receive credit. A statement of credit will be available to print immediately upon successful completion of the post test and evaluation. Commercial Support Statements
This program is supported by an educational grant from Ortho-McNeil Neurologics, Inc., administered by Ortho-McNeil Janssen Scientific Affairs, LLC.
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Upon completion of the program, click on the post-test button to register and/or access the post-test and program evaluation.
Instructions for completing and submitting the post-test are provided on the post-test screen. A minimum score of 70% on the post-test is required for a CME/CPE/CE certificate/statement.
©2008, Medical Communications Media, Inc. All rights reserved. The opinions expressed in this program are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, the American Society of Consultant Pharmacists, the National Association of Directors of Nursing Administration in Long-Term Care, or Ortho-McNeil Janssen Scientific Affairs, LLC. Any medications or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and possible contraindications or risks or without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.