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Pharmacokinetics of esmolol in children
Author(s) -
Wiest Donald B,
Trippel MAJ Donald L,
Gillette Paul C,
Garner Sandra S
Publication year - 1991
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 - 10.1038/clpt.1991.78
Subject(s) - esmolol , pharmacokinetics , medicine , anesthesia , volume of distribution , heart rate , blockade , pharmacology , blood pressure , receptor
The pharmacokinetics and concentration‐response relationships of intravenous esmolol were investigated in 20 children undergoing indicated cardiac electrophysiologic testing. A loading dose of 600 μg/kg was infused for 2 minutes. An infusion of esmolol was initiated and dosage was titrated until β‐blockade occurred. Serial esmolol blood samples were obtained for pharmacokinetic analysis. Noncompartmental pharmacokinetic analysis of the data revealed the following parameter estimates (mean ± SD): volume of distribution at steady state, 2.0 ± 1.4 L/kg; total body clearance, 321.2 ± 238.8 ml/kg/min; and terminal elimination half‐life, 4.5 ±2.1 minutes. There was a significant correlation between mean esmolol concentrations and mean percentage of reductions of mean arterial pressures and heart rates at each sample time (p < 0.001). The doses of esmolol required for β‐blockade (mean ± SD, 535 ± 180 μg/kg/min) in children were considerably higher than those typically used in adults. Esmolol should prove useful in children in the acute management of cardiac arrhythmias and hypertension. Clinical Pharmacology and Therapeutics (1991) 49 , 618–623; doi: 10.1038/clpt.1991.78