Coping with epilepsy: a pharmacist’s perspective
Public encouraged to be aware of seizures and help break the stigma
Monday, 14 February 2022, Epileptics in South Africa and around the world still sometimes face stigma, an additional burden for people living with this chronic health condition. A pharmacist from South Africa’s largest national courier pharmacy is sharing understanding about epilepsy to dispel the myths and misconceptions, while offering her expert advice for managing the condition.
“One in every 100 South Africans is epileptic, according to Epilepsy South Africa. The good news is that epilepsy can often be managed with antiepileptic medications,” says pharmacist, Joy Steenkamp, of Medipost Pharmacy.
Joy Steenkamp, pharmacist at Medipost Pharmacy
What is epilepsy?
“Epileptic episodes, or seizures, are sparked by either an overactive or an underactive electrical impulse in the brain. There are several types of seizures, and if you have never seen a person having one before, there is no need to be afraid even though it may seem distressing.”
Having a seizure does not necessarily mean the person is epileptic. The condition must be diagnosed and confirmed by a neurologist.
“The most commonly known type of seizure is the generalised tonic-clonic seizure, formerly known as grand mal seizures. These episodes often start with the person staring, then stiffness, often followed by the person falling down and uncontrollable jerking movements,” she says.
“A milder seizure may appear as though the person is ‘zoning out’ with a blank stare, sometimes they might twitch, and be unresponsive. If a seizure lasts for more than two minutes or the person has been hurt during the seizure, immediately seek medical assistance.”
Treatment for epilepsy
Antiepileptic medications (AEMs) are effective in managing the condition of some 70-80% of patients diagnosed with epilepsy, and can in many cases help to prevent or reduce seizures with minimal side effects. “This allows patients to have an improved quality of life and people with epilepsy can usually lead normal lives when they are on the correct treatment at the right dose and exactly adhere to their treatment plan,” Steenkamp says.
“For chronic medication to work best, it must be taken consistently exactly as prescribed, and if a dose is missed, never double the following dose,” Steenkamp advises.
To help make it as simple as possible for patients to adhere to their prescribed treatment, Medipost Pharmacy provides free delivery for chronic medication to any address in South Africa and once registered, patients have access to free telephonic clinical advice from the pharmacy team in their preferred South African home language relating to items dispensed by the pharmacy.
Special precautions for epileptics
As the liver is the primary organ where the body metabolizes or starts to clear medicines, certain AEMs may interfere with other medicines.
“Women using oral contraceptives should first check with their doctor, as some AEMs can lower contraceptive levels when used in combination with certain antiepileptic medicines, and increase the risk of pregnancy. The doctor could instead prescribe medicine that does not reduce the effectiveness of the oral contraceptives,” she advises.
Heart disease patients and those using the blood thinner warfarin might also experience side effects. If warfarin therapy is indicated in someone with epilepsy, the doctor will closely monitor the blood tests to check the effectiveness of warfarin and may consider switching to newer AEMs.
“Stress is known to be a primary trigger for epileptic seizures, and it is therefore very important to try to manage your stress as far as possible. Creating a routine and prioritising what is important, requires work but can be helpful to ease stress levels. Eating a balanced diet, getting sufficient sleep, drinking lots of water, doing regular exercise and having fun are well-recognised factors for a healthy lifestyle,” Steenkamp recommends.
“People with epilepsy should be aware that several common medicines available without a doctor’s prescription can lower the seizure threshold, increasing the risk of epileptic episodes. The following self-care medicines should therefore be avoided or only used in consultation with your treating doctor.”
- Diphenhydramine is an over-the-counter sleep aid. If you find that non-pharmacologic methods, such as turning off all devices at bedtime, are not working then consider discussing safe medication options with your doctor.
- Pseudoephedrine, often found in cold or sinus products, may lower the seizure threshold and increase a person’s risk of seizures. Instead use saline nasal sprays, such as those available on shop.medipost.co.za, for nasal decongestion.
- Paracetamol is the safest option to treat pain or fever in people suffering from epilepsy, and medicines containing mefenamic acid should be avoided.
Take extra care of your teeth
Epileptics are at increased risk for dental conditions, according to Steenkamp. This can be due to a variety of factors, such as trauma to teeth during a seizure, in some instances it could be avoidance of routine dental check-ups due to an increased seizure risk related to the light and loud noises during examination. This is also known to be a potential side effect of some antiepileptic medications.
“One of the older anti-epileptic medications may cause gingival hyperplasia, which is an overgrowth of the gums. Other side effects could include reduced levels of vitamin D, and this increases the risk of fractures. When this occurs in the mouth area, the person is at an increased risk for broken teeth,” she explains.
Steenkamp suggests adding vitamin D supplements to your diet, along with practising good oral hygiene to ward off the risks of tooth decay. This includes routine dental exams, avoiding sugary foods and drinks, and using protective mouth rinses with chlorhexidine or fluoride.
Ordering self-care medicines and other health, dental and beauty essentials online at https://shop.medipost.co.za/ offers a safe and easy option. Delivery is free when combined with chronic medication delivery, and for orders over R350.
Complementing this convenient remote service offering, the Medipost Walk-In Pharmacy in Gezina offers the Tshwane community face-to-face pharmacy care. It also offers a comprehensive product range including self-medication, hygiene and beauty products, as well as dispensing prescribed chronic medications and acute medicines, such as short-course antibiotics.
“We do all we can from a pharmacy perspective to support our patients in their treatment plan and help make it as convenient and cost effective as possible. As well as dispensing medicines to individuals privately, the service also includes assistance with registering PMB conditions, including epilepsy, to help conserve medical scheme members’ day-to-day benefits.
“Promoting awareness can help to improve outcomes for patients, as well as help to break the stigma surrounding epilepsy and seizures,” Steenkamp concludes.
Issued by: Martina Nicholson Associates (MNA) on behalf of Medipost Pharmacy
Contact: Martina Nicholson, Meggan Saville, and Estene Lotriet-Vorster
Telephone: (011) 469 3016