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Pharmacokinetics of nadolol in children with supraventricular tachycardia
A V Mehta1, B Chidambaram, P J Rice
1Department of Pediatrics, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614-0578.
Insights
Nadolol pharmacokinetics in children show significant age-related differences. Infants under 22 months eliminate nadolol faster, requiring cautious use in this population.
Area of Science:
- Pediatric Pharmacology
- Clinical Pharmacy
- Cardiovascular Therapeutics
Background:
- Nadolol is a beta-blocker used for supraventricular tachycardia.
- Understanding nadolol pharmacokinetics in pediatric populations is crucial for safe and effective dosing.
Purpose of the Study:
- To investigate the pharmacokinetics of intravenous and oral nadolol in children.
- To identify age-dependent variations in nadolol absorption, distribution, and elimination.
Main Methods:
- Pharmacokinetic analysis of nadolol in six pediatric patients.
- Intravenous and oral administration routes were studied.
- Age-specific pharmacokinetic parameters including half-life (t1/2) and distribution phases were assessed.
Main Results:
- Nadolol exhibited two-compartment pharmacokinetics with a distribution phase after IV administration.
- No distribution phase was observed in the youngest patient (3 months).
- Children under 22 months showed rapid nadolol elimination (t1/2 ≤ 4.3 hours) compared to older children and adults (t1/2 ≈ 7.3–15.7 hours).
Conclusions:
- Nadolol pharmacokinetics vary significantly during infancy.
- Rapid elimination in younger children necessitates careful dosing adjustments.
- Caution is advised when using nadolol in infants due to pharmacokinetic immaturity.
Abstract:
The pharmacokinetics of intravenous and oral nadolol, a long-acting beta-adrenoceptor blocking agent, were investigated in six children receiving the drug for treatment of supraventricular tachycardia. In the youngest patient (age 3 months), no distribution phase was seen. In children younger than 22 months of age, nadolol is more rapidly eliminated (t1/2 = 4.3 hours or less) than in older children, in whom elimination is more similar to that in adults (t1/2 approximately 7.3-15.7 hours). After intravenous administration, nadolol displayed two-compartment pharmacokinetics with a distribution phase (t1/2 = 0.2-1.1 hours) followed by elimination. Large changes in nadolol pharmacokinetics may occur during the first year of life. Nadolol should be used cautiously in infants.