Carbamazepine dose-concentration relationship in elderly nursing home residents.
OBJECTIVE
To describe the dose-concentration relationships of carbamazepine (CBZ) in elderly nursing home residents and the effect of sex, age, and type of co-medications.


RESULTS
This is a cross-sectional study of elderly (> or = 65 years) nursing home residents across the United States (N=92). Data collection was from 1 June 1998 to 31 December 2000. The mean CBZ dose was 9.2+/-5.4 mg/(kg day(-1)) (+/-Standard Deviation) and serum concentration was 5.9+/-2.2mg/L. The daily dose was significantly lower in the oldest-old age group (> or = 85 years, mean 476.9 mg/day (95% confidence interval CI) 326.5-627.3) as compared to the dose in the young-old (65-74 years, mean 724.4 mg/day (CI) 603.4-845.4) (p=0.016). Adjusted for body weight, doses were similar on a mg/(kg day(-1)) basis. The majority of observed CBZ serum concentrations were at the lower end (67.4%) or below (20.7%) the suggested therapeutic range for younger adult outpatients.


CONCLUSIONS
Total daily CBZ doses and patient weight decreased with age. The average dose for elderly nursing home residents was approximately 9 mg/(kg day(-1)). Carbamazepine serum concentrations were lower than those used for younger adults, suggesting that these patients may be more sensitive to CBZ.
Birnbaum
Angela K
AK
Experimental and Clinical Pharmacology, Epilepsy Research and Education Program, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA. birnb002@umn.edu
Conway
Jeannine M
JM
Hardie
Nancy A
NA
Lackner
Thomas E
TE
Bowers
Sandra E
SE
Leppik
Ilo E
IE
D000367:Age Factors; D000368:Aged / Q000502:physiology*; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use*; D002220:Carbamazepine / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012737:Sex Factors
D000927:Anticonvulsants; D002220:Carbamazepine