Prevalence of toxic anticonvulsant drug concentrations in mentally retarded persons with epilepsy.
Anticonvulsant drug concentrations in retarded individuals (117 hospital residents, 58 community-based) were surveyed. Concentrations of carbamazepine (CBZ, Tegretol) and phenytoin (Dilantin) were determined in salivary samples collected before morning medication (premedication sample) and 4 hours later (postmedication sample). Of 146 individuals receiving CBZ, 16% had salivary concentrations above the therapeutic range on at least one sample, whereas 2% exceeded the range on both samples. Of the 54 subjects prescribed phenytoin, 28% had at least one salivary concentration exceeding the therapeutic range, and 15% surpassed the therapeutic range on both samples. These data suggest the desirability of using regular therapeutic drug monitoring and neurological assessments to avoid the possibility of toxic drug levels in this population. A variety of subject and pharmacological variables (sex, severity of retardation, number of seizures in the last year, and dose) were also examined for their relationship to drug concentrations.
D000328:Adult; D002220:Carbamazepine / Q000032:analysis / Q000378:metabolism / Q000633:toxicity*; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D007700:Kinetics; D008297:Male; D010672:Phenytoin / Q000032:analysis / Q000378:metabolism / Q000633:toxicity*; D012463:Saliva / Q000032:analysis; D012737:Sex Factors
D002220:Carbamazepine; D010672:Phenytoin