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Plasma levels, half-life values, and correlation with physiologic assays for growth and immunity
Insights
This study monitored plasma prednisolone levels in children after oral prednisone. Some children showed significant variability in absorption and metabolism, impacting immune function.
Area of Science:
- Pediatric pharmacology
- Immunology
- Endocrinology
Background:
- Prednisone is a common corticosteroid treatment for children.
- Understanding its pharmacokinetics and impact on immune function is crucial.
Purpose of the Study:
- To measure plasma prednisolone levels in children after a single oral prednisone dose.
- To assess the relationship between prednisolone levels and immune markers.
- To identify variability in prednisone absorption and metabolism.
Main Methods:
- Hourly measurement of plasma prednisolone levels.
- Pharmacokinetic analysis including peak levels and half-life.
- Assessment of somatomedin activity and cell-mediated immunity.
Main Results:
- Peak prednisolone levels were observed 1-2 hours post-ingestion.
- Mean prednisolone half-life was 132 minutes.
- Significant variability in prednisone absorption and metabolism was noted in some children.
- Doses of 0.5 mg/kg or higher inhibited somatomedin activity and cell-mediated immunity.
Conclusions:
- Plasma prednisolone monitoring can identify children with excessive accumulation.
- Individual variability in prednisone metabolism necessitates careful dosing.
- Prednisolone doses of 0.5 mg/kg or higher can suppress key immune functions in children.
Abstract:
Plasma prednisolone levels have been measured hourly in children receiving a single dose of oral prednisone. Peak prednisolone levels occurred one to two hours after ingestion; half-life studies gave a mean value of 132 minutes in most children. Some children had marked variability in absorption and metabolism of prednisone. Somatomedin activity and cell-mediated immunity were inhibited by plasma prednisolone values which were achieved by single doses of prednisone of 0.5 mg/kg or higher. Monitoring prednisolone levels may be of value in identifying those children who accumulate excessively high levels on moderate dosage regimens.