Browsing by Subject "jäännöspitoisuus"

Long-term use of benzodiazepines is not recommended in the aged. Elimination of these drugs is delayed in the aged, which can prolong drug action and expose users to adverse effects. Long-term benzodiazepine use is associated with many adverse effects, including cognitive impairment and falls. However, there are only few published studies dealing with associations between benzodiazepine concentration and clinical outcomes in the aged in long-term use. The aim of this study was to explore association of residual concentration of temazepam, oxazepam and zopiclone with age, gender, kidney function, drug dose and clinical outcomes, such as self-perceived health and functional abilities in aged patients. The data were collected in Pori City Hospital in July 2004. The patients were between 60-98 years of age (median 81) and the majority (79%) of them were women. Residual drug concentrations were analysed from serum from patients using temazepam (n=14), oxazepam (n=11) or zopiclone (n=28) regularly. Residual oxazepam concentration correlated positively with evening dose (p<0.001) and daily dose (p=0.003). Also oxazepam concentration was higher (p=0.017) in patients who took the last dose later (21:00-02:45) compared to patients with earlier dosing time (15:35-19:00). There was no such association between temazepam or zopiclone and dose or dosing time. This might be explained by the fact that there was more dispersion in the dose and dosing time of oxazepam compared to temazepam and zopiclone. There were no other associations between drug concentrations and demographic variables studied. Concerning associations with clinical outcomes, zopiclone concentration tended to be higher in patients who often felt themselves tired during daytime (p=0.087). Surprisingly, residual serum concentration of oxazepam seemed to be higher in patients who were able to walk and manage their shopping independently. Apart from these findings, residual concentration of temazepam, oxazepam and zopiclone associated poorly with clinical outcomes. These findings do not support routine monitoring of residual benzodiazepine concentrations in aged patients.