PMID- 32757857
OWN - NLM
STAT- MEDLINE
DCOM- 20210304
LR  - 20220417
IS  - 1744-7607 (Electronic)
IS  - 1742-5255 (Linking)
VI  - 16
IP  - 10
DP  - 2020 Oct
TI  - Pharmacokinetic considerations about antiseizure medications in the elderly.
PG  - 983-995
LID - 10.1080/17425255.2020.1806236 [doi]
AB  - INTRODUCTION: Epilepsy represents the third most common neurological disorder in 
      the elderly. Antiseizure medications (ASMs) are often used not only to treat 
      epilepsy but also other disorders in this age group. Many physio-pathological 
      changes occur in body composition and organ or system functions with aging. 
      Furthermore, drug-drug interactions (DDIs) represent a major risk considering the 
      prevalence of polytherapy in the elderly. AREAS COVERED: Relevant studies on the 
      pharmacokinetics of ASMs in the elderly were identified through a literature 
      search. We have reviewed all available data on known alterations in 
      pharmacokinetic parameters of ASMs in elderly also considering pathophysiological 
      alterations such as renal function impairment. Finally, we have highlighted the 
      potential risk of DDIs with some drug classes. EXPERT OPINION: Large 
      interindividual variability also due to co-morbidities and related co-therapies 
      makes elderly patients a not homogeneous group. Overall, a reduction in loading 
      and maintenance doses of almost all ASMs should be considered to avoid adverse 
      events (AEs) as well as a slow titration, following the rule 'start low and go 
      slow'. Therapeutic drug monitoring should be performed to apply the 'individual 
      therapeutic concentration' and implemented to overcome the age-related 
      differences between dose and plasma concentrations, to monitor DDIs and guide 
      dosage adjustments.
FAU - Roberti, Roberta
AU  - Roberti R
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Palleria, Caterina
AU  - Palleria C
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Nesci, Valentina
AU  - Nesci V
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Tallarico, Martina
AU  - Tallarico M
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Di Bonaventura, Carlo
AU  - Di Bonaventura C
AD  - Neurology Unit, Department of Human Neurosciences, "Sapienza" University, Rome, 
      Italy.
FAU - Cerulli Irelli, Emanuele
AU  - Cerulli Irelli E
AD  - Neurology Unit, Department of Human Neurosciences, "Sapienza" University, Rome, 
      Italy.
FAU - Morano, Alessandra
AU  - Morano A
AD  - Neurology Unit, Department of Human Neurosciences, "Sapienza" University, Rome, 
      Italy.
FAU - De Sarro, Giovambattista
AU  - De Sarro G
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Russo, Emilio
AU  - Russo E
AUID- ORCID: 0000-0002-1279-8123
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
FAU - Citraro, Rita
AU  - Citraro R
AD  - Science of Health Department, School of Medicine, University of Catanzaro, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200925
PL  - England
TA  - Expert Opin Drug Metab Toxicol
JT  - Expert opinion on drug metabolism & toxicology
JID - 101228422
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anticonvulsants/administration & dosage/adverse effects/*pharmacokinetics
MH  - Dose-Response Relationship, Drug
MH  - Drug Interactions
MH  - Drug Monitoring/*methods
MH  - Epilepsy/*drug therapy
MH  - Humans
OTO - NOTNLM
OT  - Metabolism
OT  - antiepileptic drugs
OT  - antiseizure medications
OT  - distribution
OT  - drug-drug interactions
OT  - plasma proteins
OT  - renal function
EDAT- 2020/08/08 06:00
MHDA- 2021/03/05 06:00
CRDT- 2020/08/08 06:00
PHST- 2020/08/08 06:00 [pubmed]
PHST- 2021/03/05 06:00 [medline]
PHST- 2020/08/08 06:00 [entrez]
AID - 10.1080/17425255.2020.1806236 [doi]
PST - ppublish
SO  - Expert Opin Drug Metab Toxicol. 2020 Oct;16(10):983-995. doi: 
      10.1080/17425255.2020.1806236. Epub 2020 Sep 25.