title: Valproic acid doses, concentrations, and clearances in elderly nursing home residents.
abstract: VPA daily dose and total VPA concentrations for 146 elderly (> or =65 years) nursing home residents collected from June 1998 to December 2000 in homes located throughout the United States are presented. Average age was 78.5+/-8.0 years old. The mean VPA daily dose was 16.2+/-11.2mg/kg and mean total VPA concentration was 48.5+/-24.8 mg/L. The majority (56.2%) of the VPA residents are being maintained at total VPA levels <50mg/L. Mean daily dose (19.4+/-11.4, 16.3+/-12.1, and 11.3+/-7.6 mg/kg/day; p=0.003) and total VPA concentration (56.4+/-25.8, 47.7+/-22.6, and 38.7+/-23.1mg/kg/day; p=0.003) decreased by age groups (65-74, 75-84, and > or =85 years). Daily dose and total VPA concentration were not different in residents receiving inhibitory or inducing co-medications, between men and women, or by albumin level. Total VPA clearance was similar between men and women, among age groups, or according to inducing or inhibiting co-medications.
authors.affiliation: Experimental and Clinical Pharmacology, Epilepsy Research and Education Program, College of Pharmacy, University of Minnesota, 7-170 WDH, 308 Harvard St. S.E., Minneapolis, MN 55455, USA. birnb002@umn.edu
authors.forename: Angela K
authors.initials: AK
authors.lastname: Birnbaum
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hardie
authors.forename: Jeannine M
authors.initials: JM
authors.lastname: Conway
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Bowers
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Lackner
authors.forename: Nina M
authors.initials: NM
authors.lastname: Graves
authors.forename: Ilo E
authors.initials: IE
authors.lastname: Leppik
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014635:Valproic Acid / Q000493:pharmacokinetics* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid