Freedom From Treatment Failure Sample Essay.

 

After 12 months amantadine had the highest percentage free from treatment failure (79%).(Scott Perry). In Glauser et al. (2013) 53% treated with ethosuximide was free from treatment failure, 58% in valproic acid and 29 % in lamotrigine .Freedom From Treatment Failure Sample Essay.

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At 24 months ethosuximide had a free from failure rate of 75%, valproic acid had 67.8 and lamotrigine had 66.7. However there was no significant difference between the freedom- from- treatment failure rates for ethosuximide, lamotrigine and valproic acid.

The other drug therapy were not measured at 24 months.

The common reasons for treatment failure were lack of seizure control and intolerable side effects .Freedom From Treatment Failure Sample Essay.

Drug therapy , onset and long-term effects

The follow-up ranged from 14 days to 2 years. The onset of efficacy was faster for Ethosuximide compared with valproic acid and lamotrigine( see follow up Gauser et al. 2010+2013)

The long-term treatment of ethosuximide , valproic acid and lamotrigine are equally effective.

Seizure free

Children treated with either ethosuximide of valproic acid had higher seizure free rates(respectively 87 and 75) than those treated with lamotrigine.(64)

The percentage seizure free in topiramate was lowest.(33)

Adverse events (see table 3)

All studies described types of adverse events after drug therapy.

Valproic acid

A. Glauser et al. discovered the valproic acid cohort experienced a higher rate of adverse events than in the ethosuximide cohort. Attentional dysfunction was more common with valproic (49%) acid than with ethosuximide persisted at 12 months (33%) p=0,03. The increase in BMI was an adverse event leading to discontinuation of the treatment in the cohort of valproic.( glauser 2013).Freedom From Treatment Failure Sample Essay.

Lamotrigine

Holmes et al. described headache and cough after using lamotrigine. About 10% of patients using lamotrigine has a significant risk of rashes , and therefore it is recommended to increase the dose very slow. This may decrease the patients’ apllience.Freedom From Treatment Failure Sample Essay.

The adverse events were lowest in amantadine and levetiractam. Topiramate was remarkably high.(67%)

The other drugs had no specific adverse events.

6. Conclusion/discussion

The onset of seizure control in ethosuximide is faster compared with valproic acid or lamotrigine. (7)Ethosuximide and valproic acid were more effective than lamotrigine, but ethosuximide resulted in fewer attentional effects as compared with valproic acid.Freedom From Treatment Failure Sample Essay.

There were no significant differences among the three drugs with regard to discontinuation because of adverse events.

The long-term efficacy showed that ethosuximide, valproic acid and lamotrigine were equally efficacious. The newer drugs; levetiractam, amantadine and topiramate are also a possibility for treatment, but data is limited.Freedom From Treatment Failure Sample Essay.

Overall the first choice drug therapy for children with absence seizures is ethosuximide.

Limitations and recommendations

Direct comparison of drugs was challenging because of the different study population, different study designs and relative small number of patients. Also the follow up time was different in the researches. This review considered only 12 months and 24 months follow up time to compare, with the exception of Fattore et al. in which the follow-up time was 14 days. This is quite short to determine a real effect.Freedom From Treatment Failure Sample Essay.

Furthermore most studies contained information about the short-term follow-up( 1 year) except Hee Wang et al. In the future more trials are required to have especially the long-term follow- up to see the long-term adverse events, like chronic drug toxicities such as weight gain in valproic acid. It is also important in order to determine if the drug still is working. When children with absence seizures get older, there is an increased risk of generalized tonic- clonic seizures and ethosuximide has previously been reported to be limited in preventing these types of seizures. (4, 5, 7)

The newer drugs have possibly fewer side effects and are better tolerated than the older ones (ethosuximide), however few have been tested under rigorous conditions. Data of levetiractam, topiramate and amantadine is limited. Levetiractam is a promising drug, however there is little researched. The same applies for topiramate and amantadine. The number of patients was also small. The study of topiramate was early terminated because of the small sample size (n=12). The number of patients of amantadine was n =14.Freedom From Treatment Failure Sample Essay.

The studies used different measure outcomes and also the definition of the outcomes were different. For example in Hee Wang et al. the definition of seizure free was not described.Freedom From Treatment Failure Sample Essay.

In the future the outcome need to include : free from seizures, (EEG and clinical), an hyperventilation test, adverse events, psychosocial outcomes , cognitive outcome ( school performances) and attentional outcomes. There was no consideration for school performance in the studies, even though this is very relevant, because of the number of seizures a day.Freedom From Treatment Failure Sample Essay.

Most people fail at some point in their lives. It’s a necessary and fundamental part of life. People have to generally fail at something before they find success – even though failure can be defined as a lack of success, an unsuccessful person, enterprise or thing, a lack or deficiency of a desirable quality. But failure is not a means to an end, nor does failure have to give any indication of permanence. What is permanent is not getting started in the first place out of fear of failure. To fail is to fail to hit one’s target, whatever it may be, but it doesn’t prevent one from trying again.Freedom From Treatment Failure Sample Essay.

A lot of times, a person fails because they failed to adequately prepare for success. This extends to all aspects of life that people want to improve upon relationships, career-related objectives, and personal achievements. Most people want to a better life, have goals and things they want to do in life. A good deal of time and effort go into preparing for something important – any important undertaking. It seems that many people pursue success half-heartedly, with little effort and preparation, and they wonder why the fail. Preparation is the key to avoiding failure, or it at the very least minimizes one’s chances of failing. But it’s not always a certainty.Freedom From Treatment Failure Sample Essay.

Failure is not the opposite of success. It is part of success.

To lessen the likelihood of failure, one has to do things to maximize their probability of success. This can be changing one’s daily lifestyle habits, for one example. A person focused on accomplishing something, on creating success, will have to dedicate their free time to this cause. This means early nights and even earlier mornings, staying home and working instead of going out and spending money or wasting one’s time. Failure can often be attributed to a lack of commitment to success. Everyone – well, perhaps most people – strive for success. People as a whole don’t strive to fail at things in life. They generally want to excel at them.Freedom From Treatment Failure Sample Essay.

Lifestyle habits are important when considering their effect on failure, but one’s mental habits are also a key part of success. A person convinced of their success, or that it will assuredly happen in the near future, will most likely be successful in life. They are seeing their success, what it looks and feels like, play out in their minds. This is the start of the Law of Attraction at work. The Law of Attraction is a theory arguing that by focusing on positive or negative thoughts, a person can bring about positive or negative results. If a person yearns for success, thinks about it, dreams about it, always has their mind on it, the better their chances will be for them achieving success. This means they will be less likely to fail later.Freedom From Treatment Failure Sample Essay.

Failure can also be prevented with the right kind of foresight. It is a highly discussed and much-believed notion that a person’s success occurs in direct proportion to their ability to see how everything, every decision that is being made right now, affects their life down the road. People who are prone to failure live mostly for the day, or the next few days, and they neglect to consider the future – even the distant future. This is probably one of the strongest indicators of whether a person will fail or succeed in life.Freedom From Treatment Failure Sample Essay.

Success – in whatever form – is not an easy thing to come about, to find. Rather it is created from lots of hard work, preparation, persistence and unrelenting confidence. Failure, on the other hand, results from a lack of these things. To conclude, failure is the absence of success, and failure is also not a means to an end, but an opportunity to learn from failure. Everybody fails at some point in their lives. What matters most is moving forward and never giving up on success. It will happen soon enough despite failure.Freedom From Treatment Failure Sample Essay.
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