Avoid Unnecessary Drug-Related Carbohydrates for Patients Consuming the Ketogenic Diet

McGhee, Bill; Katyal, Neelam G.

doi:10.1016/s0002-8223(01)00021-9

Cited by 19 publications

(12 citation statements)

References 8 publications

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“…The ketogenic diet protocol for paediatric patients with retractable epilepsy at King Chulalongkorn Memorial Hospital; our tertiaryreferral teaching hospital, complied with the recommendations of previous studies. [11][12][13][14][15][16][17][18] Solid dosage forms; compressed tablets and hard gelatine capsules, are preferred during ketogenic diet therapy instead of oral liquid dosage forms in the equivalent doses for treatment. Chewable and disintegrating tablets are the next most suitable.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have mentioned diversity of carbohydrate content in medications and roles of pharmacists in drug selection for epileptic patients on a ketogenic diet. [12][13][14][15][16][17] Oral liquid medications such as syrups, solutions, suspensions and elixirs contain significant amounts of carbohydrate. Grams of carbohydrate per dosage unit of oral liquid dosage forms has been shown to range from 2.35 to 5.70 g, which allows very little room for additional carbohydrates from diet.…”

Section: Introductionmentioning

confidence: 99%

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The carbohydrate content of medications prescribed to children treated with a ketogenic diet

Sawangrit

Chomtho

Siritientong

2020

Pharmacy Practice and Res

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Background: Carbohydrate excipients include starches, dextrin, maltodextrin, sugar and sugar alcohols. No studies have investigated the cumulative daily carbohydrate content of medications prescribed to children with epilepsy receiving a ketogenic diet. Aims: To calculate carbohydrate contents in medications and the ketogenic ratio of children with intractable epilepsy. Methods: This retrospective study reviewed the ketogenic diet order forms of children with intractable epilepsy aged <18 years who were admitted to King Chulalongkorn Memorial Hospital, a tertiary referral teaching hospital in Thailand, from 2009 to 2017. All medications were obtained from cross-sectional medical records. The carbohydrate contents in medications were compiled by a hospital's database or requested from manufacturers. Overall carbohydrate contents in prescribed medications were calculated and included in grams of carbohydrate in ketogenic ratio. Results: A total of 169 ketogenic diet order forms of 38 epileptic patients were examined. One hundred and forty-five oral medications were prescribed, of which oral liquid medications had significantly higher carbohydrate content than solid oral dose forms (p < 0.001). Patients received a median of nine medications of which a median of four were anti-epileptic medications. The median carbohydrate content in medications was 0.99 g/day (IQR: 0.63-1.77 g/day). The significant difference of ketogenic fat:non-fat gram ratios was found when prescribed carbohydrate content in medications was higher than 2 g/day. Conclusions: Liquid medications had approximately eight times higher carbohydrate content than solid dosage forms. Comprehensive reviews of the carbohydrate content of medications and the possible association with seizure control should be performed to investigate the clinical significance of this finding.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The carbohydrate content of medications prescribed to children treated with a ketogenic diet

Sawangrit

Chomtho

Siritientong

2020

Pharmacy Practice and Res

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“…However, it was seen that consumption of the MCT diet is implicated in greater adverse effects, but overall it can be as effective as the classic KD in controlling epileptic seizures (Prasad & Stafstrom, 1998). It is known that ketosis can be inhibited by the consumption of small amounts of carbohydrates, which directly can shift the metabolism to glycolysis (VanItallie & Nufert, 2000;McGhee & Neelam, 2001). This phenomenon can be seen in patients who do not take into account or are unaware of the carbohydrate content of some foods, supplements or medications.…”

Section: Nature Of the Ketogenic Dietmentioning

confidence: 99%

“…This phenomenon can be seen in patients who do not take into account or are unaware of the carbohydrate content of some foods, supplements or medications. Especially for medications there are lists with the carbohydrate content of different medical drugs and supplements that can be received from epileptic individuals while on the KD (McGhee & Neelam, 2001).…”

Section: Nature Of the Ketogenic Dietmentioning

confidence: 99%

The ketogenic diet in children with epilepsy

et al. 2006

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Children with epilepsy, especially those facing intractable seizures, experience a great impact on the quality of their lives. Effective treatment is essential, and although new anti-epileptic drugs have shown an improved profile of action, still a substantial number of children look for more efficacious ways of treatment that are far away from potential toxicity and ineffectiveness. The ketogenic diet is a dietary therapy for epileptic children based on manipulation of metabolism principles and brain energetics. This regimen aims to produce a controlled ketonaemia through excessive dietary fat intake, little carbohydrates and adequate (for growth) protein. The present paper is a review of previous and current papers regarding the proposed mechanisms of the ketogenic diet's action, and the efficacy of the regimen on epileptic children. Unfortunately, a few small studies in sample size and duration tried to evaluate the potential risks of this regimen and their results were rather inconclusive. Further research needs to be done in order for the exact mechanism of the ketogenic diet to be clarified which will help to improve the diet's application, especially for vulnerable epileptic children as far as their growth is concerned.

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“…Já na dieta com TCM, são considerados 10% e 19% do valor energético total em proteínas e carboidratos, respectivamente 5,9 . É importante, também, considerar a quantidade de carboidratos contidos nas medicações administradas 27,28 .…”

Section: Recomendações Energéticasunclassified

Dieta cetogênica no tratamento de epilepsias farmacorresistentes

et al. 2004

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A epilepsia é uma condição clínica crônica correspondente a um grupo de doenças que tem em comum crises epilépticas; ela atinge de 0,5% a 1,0% da população dos países desenvolvidos, podendo esta prevalência ser maior nos países em desenvolvimento. Aproximadamente um terço dos pacientes evolui com crises epilépticas intratáveis com medicamentos; em alguns casos, é possível o tratamento cirúrgico. Nos pacientes em que cirurgia não é possível, a dieta cetogênica passa a ser uma opção terapêutica, principalmente em crianças.Espera-se que esta terapia seja eficaz para, pelo menos, um terço dos pacientes, resultando em redução ou controle das crises. No presente trabalho, apresentamos métodos para o preparo e uso a dieta cetogênica. O planejamento da dieta é individualizado, seguindo-se recomendações para o consumo energético e proporções de gorduras, proteínas e carboidratos específicos. Sempre que introduzida a dieta, o paciente deve ser

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Avoid Unnecessary Drug-Related Carbohydrates for Patients Consuming the Ketogenic Diet

Cited by 19 publications

References 8 publications

The carbohydrate content of medications prescribed to children treated with a ketogenic diet

The carbohydrate content of medications prescribed to children treated with a ketogenic diet

The ketogenic diet in children with epilepsy

Dieta cetogênica no tratamento de epilepsias farmacorresistentes

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