Oliguria and Tolazoline Pharmacokinetics in the Newborn.
In: Pediatrics, Jg. 77 (1986-03-01), Heft 3, S. 307-315
academicJournal
Zugriff:
Abstract. Tolazoline treatment of neonates has been reported since 1965. Dosages increased from pulse doses of 1 to 2 mg/kg to continuous infusions of 10 mg/kg, h before neonatal plasma tolazoline concentrations were measured. We developed a microassay for tolazoline and determined neonatal distribution volume, 1.61 +/- 0.21 L/ kg, and disposition rate constant (beta), 0.0027 +/- 0.005 min[sup -1] (mean +/ SEM). Half-life (y) ranged from 1.47 to 41.25 (median = 4.43) hours and correlated inversely with urine output (x); y (h) = -0.46 + 7.63/x (mL/kg.h), r = .61, P < .05. The highest plasma tolazoline concentration in a neonate was 20.3 mg/L. Lethal tolazoline concentrations in lambs ranged from 21.8 to 56.8 mg/L. Initial tolazoline concentrations during infusions and after 1- to 2-mg/kg pulse doses ranged from 0.35 to 2.3 mg/L and Pao[sub 2] increased Is greater than or equal to 15 mm Hg in 64% of 14 treatments. The average neonatal pharmacokinetics predict that each 1 mg of tolazoline HCI per kilogram pulse dose will increase the plasma concentration of tolazoline base by 0.5 mg/L. The plasma concentration should remain constant with infusion dose increments of 0.16 mg of tolazoline HCI per kilogram per hour for every 1.0-mg/kg loading dose. Tolazoline dose requirements for specific patients will vary, especially with renal dysfunction. Reduced tolazoline doses were used to treat two patients, concentrations remained constant, and Pao[sub 2] was maintained. Tolazoline doses derived from neonatal kinetics are less than current infusion doses and may avoid high concentrations. Pediatrics 1986;77:307-315; newborn, tolazoline, pharmacokinetics, oliguria, drug toxicity. [ABSTRACT FROM AUTHOR]
Titel: |
Oliguria and Tolazoline Pharmacokinetics in the Newborn.
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Autor/in / Beteiligte Person: | Ward, Robert M. ; Daniel, Catherine H. ; Kendig, James W. ; Wood, Mary A. |
Zeitschrift: | Pediatrics, Jg. 77 (1986-03-01), Heft 3, S. 307-315 |
Veröffentlichung: | 1986 |
Medientyp: | academicJournal |
ISSN: | 0031-4005 (print) |
DOI: | 10.1542/peds.77.3.307 |
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