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Pharmacokinetics of digoxin in low-birth-weight infants
Insights
Digoxin pharmacokinetics in low-birth-weight infants show that half-life is inversely related to gestational age and weight. Total body clearance is highly dependent on these factors, informing digoxin dosage recommendations.
Area of Science:
- Neonatal Pharmacology
- Pediatric Pharmacokinetics
Background:
- Digoxin is frequently prescribed for low-birth-weight infants.
- Understanding digoxin's behavior in this population is crucial for safe and effective therapy.
Purpose of the Study:
- To investigate the pharmacokinetics of digoxin in low-birth-weight infants.
- To establish relationships between pharmacokinetic parameters and infant characteristics.
Main Methods:
- Studied 13 low-birth-weight infants (820–2,710 g, 26–38 weeks gestational age).
- Utilized an open two-compartment model to describe digoxin distribution and elimination.
- Analyzed correlations between pharmacokinetic parameters (Vd, half-life, clearance) and gestational age/weight.
Main Results:
- Volume of distribution showed poor correlation with gestational age and weight.
- Digoxin half-life was inversely related to gestational age and weight (r=0.69 and 0.66).
- Total body digoxin clearance was highly dependent on gestational age and weight (r=0.87 and 0.88).
Conclusions:
- Digoxin's elimination and half-life in low-birth-weight infants are significantly influenced by gestational age and weight.
- Recommended digitalizing and maintenance digoxin dosages based on these findings.
Abstract:
Digoxin pharmacokinetics were studied in 13 low-birth-weight infants requiring digoxin therapy. Their weights ranged from 820 to 2,710 g (mean = 1,440 g) and gestational ages ranged from 26 to 38 weeks (mean = 30.9 weeks). The distribution and elimination of digoxin can be described by an open two-compartment model. Poor correlation between volume of distribution Vd beta 95.7 +/- 1.0 liters/kg) and gestational age (GA) or weight (Wt) was observed. Digoxin half-life (47 +/- 21 h) was inversely related to GA and Wt (r = 0.69 and 0.66, respectively), but total body digoxin clearance (29.8 +/- 14.7 ml/min/1.73 m2) was found to be highly dependent on these two variables (r = 0.87 and 0.88, respectively). According to the results of this study and our previous investigation, digitalizing and maintenance dosages of digoxin were recommended.