Hypothermia in elderly patients characteristics and prognosis

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Hypothermia in elderly patients characteristics and prognosis

This information is intended for use by health professionals 1. Name of the medicinal product Carbagen mg tablets 2. Qualitative and quantitative composition Each tablet contains mg Carbamazepine For a full list of excipients, see section 6.

Carbamazepine is not usually effective in absences petit mal and myoclonic seizures. Moreover, anecdotal evidence suggests that seizure exacerbation may occur in patients with atypical absences.

Hypothermia in elderly patients characteristics and prognosis

The paroxysmal pain of trigeminal neuralgia. For the prophylaxis of manic-depressive psychosis in patients unresponsive to lithium therapy.

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It is advised that a gradually increasing dosage scheme is used and this should be adjusted to suit the needs of the individual patient to achieve adequate control of seizures.

If possible a sole anti-epileptic agent should be used but if polytherapy is necessary, the same incremental dosage pattern should be followed. If adding carbamazepine to existing antiepileptic treatment, the dose should be increased gradually, and if needed, the dose of the existing antiepileptics adjusted see section 4.

Monitoring of the plasma level of carbamazepine will ensure that the optimum dose is prescribed. Carbamazepine should be taken in a number of divided doses. In some cases, mg or even mg daily in divided doses may be necessary. In elderly patients there is an increased potential for drug interactions.

Therefore, the dose of carbamazepine should be selected with caution in this group of patients.


Paediatric population and adolescents: It is advised that a gradually increasing dosage scheme is used and this should be adjusted to suit the needs of the individual patient. It may be helpful to monitor the plasma concentration of carbamazepine to establish the optimum dose see sections 4.

For children less than 5 years old it is inappropriate to prescribe carbamazepine tablets, another formulation should be used. Maximum recommendation dose Up to 6 years of age: Slowly raise the initial dosage of mg daily mg twice daily in elderly patients until freedom from pain is achieved normally at mg times daily.

In the majority of patients a dosage of mg 3 or 4 times a day is sufficient to maintain a pain free state. In some instances, dosage of mg carbamazepine daily may be needed.

However, once the pain is in remission, the dosage should be gradually reduced to the lowest possible maintenance level. When pain relief has been obtained, attempts should be made to gradually discontinue therapy, until another attack occurs.

Dosage in Trigeminal neuralgia Due to drug interactions and different antiepileptic drug pharmacokinetics, the dosage of Carbamazepine should be selected with caution in elderly patients.

In elderly patients, an initial dose of mg twice daily is recommended.Platinum-based chemotherapy consisting of either cisplatin or carboplatin is the usual first-line treatment for inoperable recurrent or metastatic squamous-cell carcinoma of the head and neck.

Haloperidol, marketed under the trade name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, nausea and vomiting, delirium, agitation, acute psychosis, and hallucinations in alcohol withdrawal.

It may be used by mouth, as an injection into a muscle, or intravenously. The prognosis depends on several factors such as exposure duration, associated injuries, comorbidities, and the degree of hypothermia.

Generally, patients with mild hypothermia will recover without any residual effects.

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Cytochrome P 3A4 (CYP 3A4) is the main enzyme catalysing formation of the active metabolite carbamazepine 10, epoxide. Adverse reactions could be induced if inhibitors of CYP 3A4 were co-administered, resulting in increased carbamazepine plasma concentrations.

EPIDEMIOLOGY. Recent epidemiological studies indicate that hospitalizations for DKA in the U.S. are increasing. In the decade from to , there was a 35% increase in the number of cases, with a total of , cases with a primary diagnosis of DKA in —a rate of increase perhaps more rapid than the overall increase in the diagnosis of diabetes ().

Suicidal ideation and behaviour have been reported in patients treated with anti-epileptic agents in several indications. A meta-analysis of randomised placebo controlled trials of anti-epileptic drugs has also shown a small increased risk of suicidal ideation and behaviour.

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