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Kinetics of urinary furosemide elimination in infants
Insights
Furosemide (F) elimination in infants shows similar urinary excretion to adults. However, infants with pneumonia and cardiac insufficiency exhibit slower F elimination, indicating potential dosage adjustments are needed.
Area of Science:
- Pharmacokinetics
- Pediatric Pharmacology
- Nephrology
Background:
- Furosemide is a diuretic commonly used in infants.
- Understanding furosemide's elimination kinetics is crucial for safe and effective dosing in pediatric populations.
- Renal function immaturity in infants may affect drug metabolism and excretion.
Purpose of the Study:
- To investigate the urinary elimination kinetics of furosemide in infants.
- To determine the elimination half-life (t1/2) of furosemide in infants using a noninvasive method.
- To compare furosemide elimination in infants with and without pneumonia and cardiac insufficiency.
Main Methods:
- A one-compartment model was used to study furosemide elimination.
- A single intravenous dose of 1 mg/kg furosemide was administered to 13 infants (9 days to 12 months) and one 23-month-old child.
- Urinary excretion data was used to determine the drug's elimination half-life noninvasively.
Main Results:
- Furosemide elimination half-life in infants ranged from 0.654 to 3.29 hours.
- Cumulative urinary excretion of furosemide in infants was comparable to healthy adults.
- Infants with pneumonia and cardiac insufficiency had a significantly longer mean furosemide elimination half-life (2.15 h) compared to those with pneumonia alone (1.01 h).
Conclusions:
- Renal function immaturity in the first year of life does not appear to significantly impact the elimination kinetics of a 1 mg/kg intravenous furosemide dose in infants.
- Slower furosemide elimination in infants with pneumonia and cardiac insufficiency suggests a need for careful dosage consideration in these patients.
- Further research may be warranted to explore the impact of specific disease states on furosemide pharmacokinetics in infants.
Abstract:
Using a one-compartment model, the urinary elimination kinetics of a single intravenous 1 mg/kg dose of furosemide (F) was studied in 13 infants, 9 days to 12 months old (mean 3.7 +/- (SD) 3.48 months old), and 1, 23-month-old child, with bilateral multifocal pneumonia, recovering from respiratory and cardiac insufficiency accompanying pneumonia and/or other diseases. F elimination half-life was determined with the use of a noninvasive method based on the drug's urinary excretion data. The drug urinary elimination t1/2 in the infants ranged from 0.654 to 3.29 h. Cumulative excretion of F in the infants' urine was similar to the values in healthy adults. Since the furosemide urinary half-lives found in infants were similar to the data reported in older children and healthy adults it is suggested that immaturity of renal function during the 1st year of life, i.e. in older infants, has no evident on the elimination kinetics of a 1 mg/kg intravenous dose of F. Mean F urinary elimination t1/2 in infants with pneumonia and cardiac insufficiency was significantly longer compared with the Ft1/2 found in children with the pneumonia alone (2.15 vs. 1.01 h, respectively), suggesting slower elimination of the drug in these patients.