Clinical pharmacokinetics of phenobarbital in neonates

Demographic and clinical pharmacokinetic data collected from term and preterm neonates who were treated with intravenous phenobarbital have been analysed to evaluate the role of patient characteristics in pharmacokinetic parameters. Significant relationships between total body weight (TBW) or body s...

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Bibliographic Details
Published in:European journal of pharmaceutical sciences 2000-12, Vol.12 (2), p.111-116
Main Authors: Touw, D.J, Graafland, O, Cranendonk, A, Vermeulen, R.J, van Weissenbruch, M.M
Format: Article
Language:English
Subjects:
Analgesics
Anticonvulsants - administration & dosage
Anticonvulsants - pharmacokinetics
Anticonvulsants - therapeutic use
Biological and medical sciences
Body Constitution
Epilepsy, Benign Neonatal - blood
Epilepsy, Benign Neonatal - drug therapy
Female
Gestational age
Humans
Hypnotics. Sedatives
Infant, Newborn
Infant, Premature
Infusions, Intravenous
Male
Medical sciences
Metabolic Clearance Rate
Neonate
Neuropharmacology
Pharmacokinetics
Pharmacology. Drug treatments
Phenobarbital
Phenobarbital - administration & dosage
Phenobarbital - pharmacokinetics
Phenobarbital - therapeutic use
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Regression Analysis
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Summary:Demographic and clinical pharmacokinetic data collected from term and preterm neonates who were treated with intravenous phenobarbital have been analysed to evaluate the role of patient characteristics in pharmacokinetic parameters. Significant relationships between total body weight (TBW) or body surface area (BSA) and volume of distribution (Vd) and total body clearance (CL) were found. Coefficients of determination were: 0.55 and 0.59 for Vd, and 0.76 and 0.72 for CL against TBW and BSA, respectively. In addition, significant relationships between height of the infants and volume of distribution of phenobarbital and total body clearance were observed. Coefficients of determination were 0.58 for Vd and 0.56 for CL. A weaker but significant correlation existed between gestational age and Vd or CL of phenobarbital. Coefficients of determination were 0.43 and 0.64, respectively. There was no correlation between volume of distribution per kg body weight or total body clearance per kg body weight and any patient parameter investigated. However, these latter pharmacokinetic parameters tended to decrease with increasing gestational age and height of the neonates. The results obtained were used to develop new loading and maintenance doses for phenobarbital in neonates based on total body weight and body surface area and based on height and gestational age for cases that weight is not available.
ISSN:0928-0987
1879-0720
DOI:10.1016/S0928-0987(00)00145-7