Christine Kubus, 2016 PharmD Candidate

	Some evidence suggests that a febrile seizure occurs when the child has low serum zinc levels.

Between 2% to 5% of children will experience a febrile seizure at some point. These seizures, which follow rapid body temperature elevations, occur most often in children ages 6 months to 2 years and peak in the second year of life.

Zinc is an important player in the levels of gamma-aminobutyric acid (GABA), a main inhibitory neurotransmitter in the brain. Zinc activates a pyridoxal kinase enzyme that decarboxylates glutamic acid and increases the brain’s GABA levels, thereby preventing excitatory neuronal discharge.  As a result, zinc deficiencies may lead to less GABA formation.

 recently published a study that analyzed 100 children between the ages of 18 months to 60 months to determine the effects of zinc supplementation.  

Patients had a history of 1 febrile seizure and were randomized to receive 2 mg/kg/day of zinc sulfate supplementation or placebo for 6 months.

The primary endpoint was rate of recurrent seizures. The researchers followed patients for 1 year after the trial was initiated.

Febrile seizure recurrence was seen in 19 patients from the placebo arm (38%) and 11 patients from the active supplementation arm (22%), which was a statistically significant difference. 

Risk factors for recurrence were male gender, children with a family history of seizures, and children with a lower serum zinc concentration at the start of the study.

The study authors concluded that zinc supplementation appears to be safe way to prevent febrile seizures.

Vomiting, heartburn, and abdominal pain were reported as adverse effects in the study participants. However, these effects were “well-tolerated” and disappeared in 2 to 3 weeks, and supplementation was continued. Overall, there was no statistically significant difference between the 2 groups in terms of safety.

The researchers noted that multiple prior studies showed little effect of zinc supplementation on the recurrence of febrile seizures.

Since the sample size of this study was small and the results were not consistent with prior research, zinc supplementation for febrile seizure prevention warrants further research.

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Some evidence suggests that a febrile seizure occurs when the child has low serum zinc levels.


Could Zinc Supplements Help Prevent Febrile Seizures?

Seven in 10 patients report some extent of nonadherence prior to a hospitalization caused by a cardiovascular event such as acute cardiac failure.

Multiple studies have looked at medication adherence and health outcomes, but their findings have been inconclusive and often contradictory.

 has identified risk factors for nonadherence after analyzing 1967 patients hospitalized with an acute cardiac event.

With this information, pharmacists can develop interventions that improve adherence and patient outcomes.

Risk factors investigated in the study included health literacy, health numeracy, and health competency. In addition, the researchers investigated sex, race, age, income, marital status, social support, depression, education, and diagnosis.

The study showed that low health literacy, low numeracy, low health competency, nonwhite race, younger age, male sex, less social support, and more depressive mood are significant risk factors for nonadherence.

Of these risk factors, health literacy, health numeracy, health competency, social support, and depression are modifiable and potential targets for pharmacist interventions.

The investigators indicated that comprehensive, team-based care using educational, behavioral, and social interventions can overcome these barriers.

Pharmacists can advocate for patients and ensure that they understand written and numerical information. They can also suggest devices that help patients remember to take their medication.

Pharmacists can also monitor for adherence and ensure that patients with acute coronary syndrome have or can find the resources for social support.

By identifying and understanding the cause of nonadherence, pharmacists can help reduce hospitalizations through adherence interventions. 

Seven in 10 patients report some extent of nonadherence prior to a hospitalization caused by a cardiovascular event such as acute cardiac failure.
