Iron supplements in nursing home patients associated with reduced carbamazepine absorption
| Autor: | Ilo E. Leppik, Richard C. Brundage, Sai Praneeth Reddy Bathena, Angela K. Birnbaum, Jeannine M. Conway, Jae Eun Ahn |
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| Rok vydání: | 2018 |
| Předmět: |
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medicine.medical_specialty Health Services for the Aged Iron Absorption (skin) 030226 pharmacology & pharmacy Statistics Nonparametric 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Internal medicine Humans Medicine Dosing Aged Aged 80 and over Volume of distribution Epilepsy business.industry Carbamazepine United States Nursing Homes Bioavailability Neurology Dietary Supplements Iron supplementation Anticonvulsants Female Independent Living Neurology (clinical) Drug Monitoring business Nursing homes 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Epilepsy Research. 147:115-118 |
| ISSN: | 0920-1211 |
| DOI: | 10.1016/j.eplepsyres.2018.07.015 |
| Popis: | Persons in nursing homes receive a number of medications that may interfere with the pharmacokinetics of carbamazepine (CBZ). The aim of our study was to determine factors that may affect the pharmacokinetics of CBZ in elderly nursing home patients. Methods CBZ concentration data collected from 60 nursing homes across the US were evaluated. Inclusion criteria included residency in a nursing home for at least 2 months, age 65 years or older, a stable dosing regimen of CBZ for at least 4 weeks (considered steady state), available CBZ concentration, and complete information regarding all co-medications. Using a nonlinear mixed-effects model, the data were adequately described by a one-compartment model with first-order absorption and elimination. Goodness-of-fit plots, plausibility of parameter estimates, visual predictive check and nonparametric bootstrap were used to evaluate the models. Main findings The final data set consisted of 345 CBZ concentrations from 99 subjects (38 males, 61 females). The population estimate of apparent clearance (CL/F) for a 70-kg person was 3.69 L/hr (RSE 6.9%). Residents were receiving either immediate (93.9%) or extended release (6.1%) formulation of CBZ and the Ka of each formulation was fixed to literature values. Age, sex, and co-medications had no effect on CL/F and apparent volume of distribution. Iron supplementation, which was taken by 16% of the residents, resulted in a 33% decrease in bioavailability (p Conclusions Results from this pharmacokinetic study indicate that use of iron supplementation is associated with a reduction in absorption of CBZ and may need to be considered when dosing CBZ in patients taking iron supplementation. |
| Databáze: | OpenAIRE |
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