Pharmacokinetics of intravenous paracetamol in children and adolescents under major surgery

Würthwein, Gudrun; Koling, Susanne; Reich, Alexander; Hempel, Georg; Schulze-Westhoff, P.; Pinheiro, Paulo V.; Boos, Joachim

doi:10.1007/s00228-004-0873-6

Cited by 25 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The range of median t1/2s we obtained (1.6 -2.2 h) for the paediatric age groups agrees with the range (1.0 -2.8) previously reported for both children and adults (Bannwarth et al, 1992;Autret et al, 1993;Prescott, 1996;Wurthwein et al, 2005). Being a derived PK parameter, t1/2 is related to the two fundamental PK parameters, Cl and Vd, (directly to clearance, and inversely to distribution volume), which explains why it is not also influenced by age in our study.…”

Section: Discussionsupporting

confidence: 92%

“…The PK values, CLt, Vd and t1/2, obtained were not significantly affected by age, weight, height, BMI or BSA, lending further support to the suggestion that the overall mechanisms involved in paracetamol elimination have reached adult capacity by the age of 2 years (Miller et al, 1976). Although the halflife for paracetamol obtained is similar to that reported by Wurthwein et al, (2005), the median values for the CLt/70 kg (21.7 -28.7 lh -1 ) are far higher compared to the 13.2 lh -1 reported by Wurthwein et al,. The reasons for this difference are not clear but could however be attributed to the size of study subjects recruited in the study by Wurthwein et al, which included only 7 subjects.…”

Section: Discussionsupporting

confidence: 82%

“…Although intravenous paracetamol is frequently used for pain control in children there is just one report (Wurthwein et al, 2005) on the pharmacokinetic properties of this form of paracetamol in children of different ages.…”

Section: Introductionmentioning

confidence: 99%

“…The assessment of this new formulation of paracetamol by Wurthwein et al, (2005) has been done in 7 children aged 10.3 -16.6 years; however there is limited data for younger children in whom this formulation is frequently used. The lack of pharmacokinetic information for this formulation of paracetamol has resulted in it being highlighted as a medicine under surveillance by regulatory bodies such as the Medicines and Healthcare-product Regulatory Agency (MHRA-UK) (SPC, 2009).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pharmacokinetics of Single Dose Intravenous Paracetamol in Children

Mohammed¹,

Cameron²,

Pj³

et al. 2014

J. Med. Biomed. Sci.

View full text Add to dashboard Cite

A new intravenous formulation containing paracetamol is now available and widely used in children, but with limited paediatric pharmacokinetic data. This study was aimed at determining the effects of age on the pharmacokinetics (PK) of this formulation of paracetamol in children. Blood samples were obtained from 24 children at 0, 15, 30 minutes, then 1, 2, 4, 6 and 8 hours after the administration of 15 mg kg -1 of IV paracetamol. Paracetamol was quantified using an HPLC-UV method, with lower limit quantification of 2200 pg and an intra-assay coefficient of variation of 3%. In the paediatric age groups 2-5 years, 6 -10 years and 11-14 years, total clearance (CLt) in kg l -1 h -1 , was 0.41(0.20-0.57), 0.31(0.14-1.10) and 0.37(0.09-0.55) respectively; volume of distribution (Vd) in litres was 0.90(0.7-1.1), 0.95(0.7-1.6) and 0.90(0.4 -1.3) respectively; and elimination half-lives (t1/2) in hours was 1.7(1.1-2.6), 2.2(0.6-3.5) and 1.6(1.1-4.7), respectively. The PK parameters (CLt, Vd and t1/2) obtained did not differ significantly among the paediatric age groups (the p-value in all cases was greater than 0.05). In children 2-14 years, there were no significant relationships between the PK parameters and age, weight, height, body weight or body surface area.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacokinetics of Single Dose Intravenous Paracetamol in Children

Mohammed¹,

Cameron²,

Pj³

et al. 2014

J. Med. Biomed. Sci.

View full text Add to dashboard Cite

show abstract

“…Only a limited amount of pharmacokinetic and pharmacodynamic studies have been performed with this formulation [4][5][6]. A study in a small group of healthy male volunteers showed a mean peak serum concentration (C max ), observed at the end of a 15-min i.v.…”

Section: Introductionmentioning

confidence: 99%

Paracetamol for intravenous use in medium- and intensive care patients: pharmacokinetics and tolerance

Maat

Tijssen

Brüggemann

et al. 2010

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Purpose We studied the pharmacokinetics of paracetamol and determine the incidence of hypotension after intravenous administration in medium-(MCU) and intensive care (ICU) patients. Methods All patients on the ICU/MCU starting with paracetamol i.v. were included, yielding 38 patients. Blood samples were collected at predetermined time points to determine paracetamol serum concentration. The number of patients with a clinically relevant reduction in systolic blood pressure (SBP) and the number of patients that needed intervention to regain an acceptable blood pressure level were assessed. Results Overall, pharmacokinetic data were roughly comparable with earlier publications, but differences were noted in the subgroup ICU patients. Also, there was a trend to a larger peak serum concentration (p=0.052) and a significantly smaller volume of distribution (p=0.033) in MCU patients compared with ICU patients. Twenty-two percent (22%) and 33% of patients had a clinically relevant reduction in systolic blood pressure (SBP) 15 and 30 min after start of paracetamol infusion, respectively. In six patients (16%), an intervention was needed to correct blood pressure. Overall, SBP was significantly reduced at T=15 min and 30 min postinfusion (p<0.003 at both time points) when compared with SBP at the start of paracetamol infusion. Conclusions Further research on differences in paracetamol pharmacokinetics between ICU and MCU patients is warranted, as these differences might result in differences in efficacy. Furthermore, administration of paracetamol i.v. as potential cause of hypotension in the critically ill patient must not be overlooked.

show abstract

Population pharmacokinetics of intravenous acetaminophen in Japanese patients undergoing elective surgery

et al. 2017

View full text Add to dashboard Cite

show abstract

Pharmacokinetics of intravenous paracetamol in children and adolescents under major surgery

Abstract: Surgery, with all its potential influencing factors, together with chemotherapy given about 4 weeks previously do not seem to have a major impact on the pharmacokinetic behavior and the between-subject variability of paracetamol after intravenous administration.

Cited by 25 publications

References 18 publications

Pharmacokinetics of Single Dose Intravenous Paracetamol in Children

Pharmacokinetics of Single Dose Intravenous Paracetamol in Children

Paracetamol for intravenous use in medium- and intensive care patients: pharmacokinetics and tolerance

Population pharmacokinetics of intravenous acetaminophen in Japanese patients undergoing elective surgery

Contact Info

Product

Resources

About