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Pharmacokinetics of glycopyrrolate in children
P Rautakorpi1, T Ali-Melkkilä, T Kaila
1Department of Anesthesiology, Turku University Hospital, Finland.
Insights
This study found that glycopyrrolate pharmacokinetics in children are generally consistent across age groups. A slightly shorter elimination half-life in 1-3 year olds was observed but deemed clinically insignificant.
Area of Science:
- Pediatric Pharmacology
- Clinical Pharmacokinetics
- Anesthesiology
Background:
- Glycopyrrolate is an anticholinergic medication used in pediatric anesthesia.
- Understanding its pharmacokinetic profile in children is crucial for safe and effective dosing.
Purpose of the Study:
- To investigate the pharmacokinetics of glycopyrrolate in pediatric patients.
- To assess potential age-related differences in glycopyrrolate's absorption, distribution, metabolism, and excretion.
Main Methods:
- An open-label study involving 26 healthy children undergoing minor surgery.
- Patients were divided into three age groups: under 1 year, 1-3 years, and over 3 years.
- Glycopyrrolate (5 mcg/kg) was administered intravenously, with plasma concentrations monitored over 480 minutes.
Main Results:
- No significant differences in distribution volume or clearance were found across age groups.
- A statistically significant, but clinically minor, shortened elimination half-life of glycopyrrolate was observed in children aged 1-3 years.
- No significant alterations in heart rate were detected post-administration.
Conclusions:
- Glycopyrrolate exhibits predictable pharmacokinetics in children across different age ranges.
- The observed minor pharmacokinetic variation in younger children does not necessitate dosage adjustments.
- The study confirms the safety and pharmacokinetic consistency of glycopyrrolate in pediatric patients.
Study Objective:
To investigate the pharmacokinetics of glycopyrrolate in children.
Design:
Open study with three parallel groups.
Setting:
Pediatric surgery department at a university hospital.
Patients:
26 healthy ASA physical status I children undergoing minor surgery.
Interventions:
Patients were assigned to 1 of 3 groups: under 1 year of age (Group 1, n = 8), between 1 and 3 years of age (Group 2, n = 7), and over 3 years of age (Group 3, n = 11). Glycopyrrolate 5 micrograms/kg was given as a single intravenous (i.v.) injection before induction of general anesthesia. Blood samples (for determination of drug concentrations in plasma) were collected via venous cannula inserted into the contralateral antecubital vein.
Measurements And Main Results:
ECG was observed continuously, blood pressure was measured with an automatic noninvasive device, and blood samples were taken just before and at 2, 4, 6, 10, 15, 30, 60, 120, 180, 240, 360, and 480 minutes after injection of glycopyrrolate. Glycopyrrolate concentrations in plasma were determined with a radioreceptor assay. The only significant difference in the pharmacokinetic parameters was the shortened elimination half-life in patients between 1 and 3 years of age. Glycopyrrolate 5 micrograms/kg i.v. did not cause any significant alterations in heart rate.
Conclusions:
There were no significant changes in the distribution volume or clearance of glycopyrrolate in children of different ages. The shortened elimination half-life in children between 1 and 3 years of age is of minor clinical importance.