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Uptake pharmacokinetics of the Fentanyl Oralet ® in children scheduled for central venous access removal: implications for the timing of initiating painful procedures
Author(s) -
Wheeler Melissa,
Birmingham Patrick K.,
Dsida Richard M.,
Wang Zhao,
Coté Charles J.,
Avram Michael J.
Publication year - 2002
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2002.00949.x
Subject(s) - fentanyl , medicine , pharmacokinetics , anesthesia , bioavailability , absorption (acoustics) , pharmacology , physics , acoustics
Summary Background : The Fentanyl Oralet ® (Abbott Laboratories, Abbott Park, IL, USA) is an oral transmucosal drug delivery system. We previously examined pharmacokinetic parameters of children who had completed consumption of the Fentanyl Oralet ® . The present study was designed to clarify pharmacokinetic parameters during the consumption phase to determine if there is an optimal administration time before painful procedures. Methods : Patients, aged 3–10 years, who were scheduled for elective removal of central venous access devices under general anaesthesia, received a Fentanyl Oralet ® (fentanyl 10–15 µg·kg −1 ). Plasma fentanyl concentrations were measured by radioimmunoassay. Data from blood samples obtained during and after consumption of the Fentanyl Oralet ® from 17 patients in the present study were combined with data from our previous study to better characterize both the consumption and postconsumption concentration versus time profiles. Results : Estimated fentanyl bioavailability (mean ± SD) was low (36.1 ± 0.4%), as were peak plasma concentrations (1.03 ± 0.31 ng·ml −1 ), suggesting that many children swallowed a large fraction of the dose. This led to a relatively late and variable peak concentration time of 53 ± 40 min. In addition, because of the apparently large degree of gastrointestinal absorption, concentration versus time curves were wide and flat. Conclusions : The wide and flat concentration versus time profile may allow flexibility in the timing of a painful procedure following Fentanyl Oralet ® administration. However, the variability of the time to peak concentration makes it difficult to suggest a minimum interval between Fentanyl Oralet ® consumption and the start of a painful procedure.