The pharmacokinetics of isoproterenol in critically ill pediatric patients.

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Reyes G, Schwartz PH, Newth CJ, Eldadah MK

The pharmacokinetics of isoproterenol in critically ill pediatric patients.

J Clin Pharmacol. 1993 Jan;33(1):29-34. doi: 10.1002/j.1552-4604.1993.tb03899.x.

PubMed ID
8429110 [ View in PubMed
]
Abstract

The pharmacokinetics of isoproterenol (ISO) in infants and children have never been reported. The authors studied ISO pharmacokinetics in two disparate groups of pediatric intensive care unit patients: postoperative cardiac patients (POC, n = 10), and reactive airway disease patients (RAD, n = 9). In all, 44 blood samples were taken at steady-state from the 19 patients, whereas from 15 patients samples were also taken just before and after discontinuation of ISO infusion. There were 12 male and 7 female patients in the study, and their ages ranged from 2 days to 14 years. The average ISO dosing rate was 0.30 micrograms/kg/minute for the whole study population, ranging from 0.01 to 5.5 micrograms/kg/minute. The POC patients received a significantly lower dosing rate than the RAD patients (0.029 +/- 0.002 vs 0.50 +/- 0.21 micrograms/kg/minute, P < .0001); the average steady-state plasma concentrations of ISO were also lower in the POC patients (1.3 +/- 0.3 versus 13.9 +/- 4.9 ng/mL, P < .0001). The steady-state plasma concentration, normalized to a dosing rate of .05 micrograms/kg/minute, was 1.9 +/- 0.3 ng/mL for all patients, and the clearance was 42.5 +/- 5.0 mg/kg/minute. Postoperative cardiac patients had a significant higher normalized steady-state plasma concentration and moderately significant lower clearance than did RAD patients (2.1 +/- 0.3 versus 1.7 +/- 0.4 ng/mL, P < .05 and 33.2 +/- 4.9 versus 48.4 +/- 7.3, P < .06, respectively). The average plasma half-life of ISO was 4.2 +/- 1.5 minutes, and the volume of distribution was 216 +/- 57 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS)

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