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Pharmacokinetics of ketorolac in children after abdominal surgery
G González-Martin1, L Maggio, J González-Sotomayor
1Department of Pharmacy, Faculty of Chemistry, Catholic University of Chile, Santiago, Chile.
Insights
This study found that two doses of intravenous ketorolac had similar pharmacokinetic profiles in children aged 2-8 years. These findings suggest consistent drug behavior across different pediatric dosages.
Area of Science:
- Pediatric Pharmacology
- Clinical Pharmacokinetics
- Pain Management
Background:
- Ketorolac is a nonsteroidal anti-inflammatory drug used for pain relief.
- Understanding ketorolac pharmacokinetics in children is crucial for safe and effective dosing.
- Previous pharmacokinetic data primarily exists for adult populations.
Purpose of the Study:
- To evaluate the pharmacokinetics of two different intravenous ketorolac doses in pediatric patients.
- To compare the distribution volume, total clearance, and elimination half-life between the two doses.
- To identify any significant differences in ketorolac's drug behavior in children.
Main Methods:
- A pharmacokinetic study involving 14 children aged 2-8 years.
- Administration of two intravenous ketorolac doses: 0.5 mg/kg and 0.9 mg/kg.
- Serial blood sampling for 6 hours post-administration.
- Assay of serum ketorolac concentrations using high-performance liquid chromatography (HPLC).
- Estimation of pharmacokinetic parameters via nonlinear computer analysis.
Main Results:
- Distribution volume (Vdarea), total clearance (Cltotal), and elimination half-life (t1/2 beta) were comparable between the 0.5 mg/kg and 0.9 mg/kg ketorolac groups.
- Ratios for Vdarea, Cltotal, and t1/2 beta (0.9:0.5 mg/kg) were 1.24, 1.14, and 1.083, respectively, indicating similarity.
- Pharmacokinetic parameters in children differed from those reported in adult subjects.
Conclusions:
- Intravenous ketorolac exhibits similar pharmacokinetic characteristics in children across the studied dose range (0.5 and 0.9 mg/kg).
- The findings suggest that ketorolac's disposition in children is consistent, supporting established dosing guidelines.
- Pediatric pharmacokinetic profiles for ketorolac appear distinct from adult profiles, highlighting the need for age-specific considerations.
Abstract:
The pharmacokinetics of 2 doses of intravenous ketorolac (0.5 and 0.9 mg x kg-1) were studied in 14 children (age 2-8 years). A single dose of the drug was injected into the dorsum vein of one hand. Blood samples were collected at regular time intervals for 6 hours. Serum ketorolac concentrations were assayed using a high pressure liquid chromatography method. Pharmacokinetic values were estimated by a nonlinear computer program. The distribution volume (Vdarea), the total clearance (Cltotal), and elimination half-life (t1/2 beta) were similar in both groups of children who either received 0.5 or 0.9 mg x kg-1 of ketorolac. The estimated geometric mean Vdarea, Cltotal, and t1/2 beta ratios (95% CI in parentheses) for 0.9 mg x kg-1:0.5 mg x kg-1 were 1.24 (0.82, 1.50), 1.14 (0.88, 1.23), and 1.083 (0.40, 1.81), respectively. The pharmacokinetic parameters found in this study are different from those found by other authors in adult subjects.