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Absorption pharmacokinetics of clonidine nasal drops in children

Nicole Almenrader1, Peter Larsson, Maurizio Passariello

  • 1Department of Anaesthesia and Intensive Care, University Hospital, Policlinico Umberto I, Rome, Italy. n.almenrader@gmail.com

Paediatric Anaesthesia
|January 16, 2009
PubMed

Insights

Clonidine nasal drops show poor and inconsistent absorption in children, making them unsuitable for premedication. This study highlights the variability and delayed absorption of clonidine via the nasal route.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacokinetics
  • Drug Delivery Systems

Background:

  • Clonidine is a commonly used alpha2 agonist for pediatric premedication.
  • Established pharmacokinetic data exists for oral, rectal, and intravenous clonidine administration.
  • Nasal administration offers a potential alternative route for drug delivery.

Purpose of the Study:

  • To investigate the absorption pharmacokinetics of clonidine administered as nasal drops in pediatric patients.
  • To evaluate the efficacy and safety of clonidine nasal drops for premedication.

Main Methods:

  • A study involving thirteen pediatric patients (ASA I) receiving clonidine (4 mcg x kg(-1)) intranasally post-anesthesia induction.
  • Plasma clonidine levels were monitored over 12 hours.
  • Analysis utilized liquid chromatography-mass spectrometry and computer-aided curve fitting.

Main Results:

  • Clonidine nasal drops exhibited significant interindividual pharmacokinetic variability.
  • Absorption was characterized by delays and limitations.
  • Key pharmacokinetic parameters included a 95% CI for Cmax of 0.4-0.6 ng x ml(-1) and Tmax of 1.4-3.0 h.

Conclusions:

  • Clonidine nasal drops demonstrate erratic absorption from the nasal mucosa in children.
  • This route of administration is not recommended for pediatric premedication due to unpredictable absorption.
Abstract

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