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[The pharmacokinetics of pancuronium bromide in infants, children and adults]
Insights
Pancuronium bromide pharmacokinetics differ significantly with age. Younger patients exhibit larger distribution volumes and higher clearance, impacting drug dosing in pediatric anesthesia.
Area of Science:
- Pharmacology
- Anesthesiology
- Biopharmaceutics
Context:
- Pancuronium bromide is a neuromuscular blocking agent used in anesthesia.
- Understanding its pharmacokinetics is crucial for safe and effective drug administration.
- Age-related differences in drug metabolism and distribution are well-documented.
Purpose:
- To investigate the pharmacokinetics of pancuronium bromide in pediatric and adult patients.
- To determine how age influences the distribution, clearance, and elimination of pancuronium bromide.
- To establish age-specific pharmacokinetic parameters for pancuronium bromide under enflurane anesthesia.
Summary:
- This study analyzed pancuronium bromide pharmacokinetics in 24 patients undergoing plastic surgery, stratified into infants, children, and adults.
- Plasma concentrations were measured using a fluorimetric assay after a 100 µg/kg dose.
- Results indicated a two-compartment open model best describes pancuronium bromide disposition across all age groups.
- Younger patients showed larger distribution volumes and higher clearance (Cl). Significant differences in V1, V2, Vdss, Cl, and AUC were observed between age groups.
- Half-life (T1/2 beta) and mean residence time (MRT) were prolonged in infants compared to children and adults.
Impact:
- Provides critical pharmacokinetic data for optimizing pancuronium bromide dosing in pediatric anesthesia.
- Highlights the need for age-specific dosing considerations to ensure patient safety and efficacy.
- Contributes to a better understanding of age-dependent drug disposition in neuromuscular blocking agents.
Abstract:
Twenty-four patients scheduled for elective plastic surgery were selected to study the pharmacokinetics of pancuronium bromide under enflurane anesthesia. The patients were divided into three groups by their ages; Group 1 consisted of 5 infants (0.75-2.95 years); Group 2 contained 13 children (4-14 years); Group 3 included 6 adults (16-27 years). An improved fluorimetric assay was used to measure the plasma concentrations of pancuronium bromide after administration of pancuronium bromide at a dose of 100 micrograms/kg. The results showed that the disposition of pancuronium bromide may be best described mathematically by a two-compartment open model in all patients. The younger the patients, the larger the distribution volumes and the higher the Cl. There were significant differences among the three groups with regard to V1, V2, Vdss, Cl, AUC. The T1/2 beta and MRT were longer in Group 1 than in Group 2 and Group 3.