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Pharmacokinetics of acetaminophen rectal suppositories in infants post cardiovascular surgery
Author(s) -
Torres A.,
Graumlich J. F.,
Skender K. M.,
Wohrley J. D.,
Geiss D. M.
Publication year - 2004
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2003.11.279
Subject(s) - acetaminophen , pharmacokinetics , fluorescence polarization immunoassay , medicine , anesthesia , analgesic , dosing , rectal administration , pharmacology
Purpose Dosing recommendations for rectal acetaminophen to treat post‐operative pain in infants after cardiovascular surgery are not established. Methods 20 children (age 0.4 ± 0.4 years, weight 5.6 ± 1.8 kg) received acetaminophen 40 mg/kg immediately post operative then 20 mg/kg at 6, 12, 18 hours. Administered doses were combinations of uncut rectal suppositories (80, 120, or 325 mg) to approximate the target dose. Serial blood samples were analyzed for acetaminophen by fluorescence polarization immunoassay. Pharmacokinetic analysis determined model‐dependent parameters by curve fitting of serum concentrations versus time. Results Pharmacokinetic parameter estimates, mean (CV%), standardized to 70‐kg person using allometric size model. (See Table) Acetaminophen concentrations between 1 and 24 hours after the first dose were 17.6 ± 9.1 mg/L. Conclusions Pharmacokinetic parameters were consistent with previous studies of rectal acetaminophen. Rectal acetaminophen 40 mg/kg followed by 20 mg/kg every 6 hours achieves acetaminophen concentrations within therapeutic range in infants during the first 24 hours after cardiovascular surgery. Clinical Pharmacology & Therapeutics (2004) 75 , P74–P74; doi: 10.1016/j.clpt.2003.11.279Cl/F (L/hr/70 kg) V/F (L/70 kg) T lag (hr) 7.6 (47%) 78.3 (87%) 0.6 (150%)