Pharmacokinetics of Nadolol in Children with Supraventricular Tachycardia

Mehta, Ashok V.; Chidambaram, B.; Rice, Peter J.

doi:10.1002/j.1552-4604.1992.tb03805.x

Cited by 15 publications

(19 citation statements)

References 14 publications

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“…Pope et al recently reported a study comparing oral nadolol (10 patients) with oral propranolol (9 patients) for the treatment of IHs and found a faster response in the nadolol group. Nadolol has also been shown to be effective and safe when used orally or intravenously for supraventricular tachycardia in children .…”

Section: Discussionmentioning

confidence: 99%

Oral Nadolol for Children with Infantile Hemangiomas and Sleep Disturbances with Oral Propranolol

Bernabéu‐Wittel

Narváez-Moreno

Torre-García

et al. 2015

Pediatric Dermatology

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The use of oral nadolol in the treatment of IH in our series of 7 patients, resolved the propranolol-related sleep disturbances in 5 (71%), while in one patient the symptoms recurred after 4 months of oral nadolol at a dose of 2 mg/kg/day. In most cases, switching beta-blockers did not compromise efficacy, and is recommended when sleep disturbance necessitates discontinuation of beta-blocker therapy of IH.

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Section: Discussionmentioning

confidence: 99%

Oral Nadolol for Children with Infantile Hemangiomas and Sleep Disturbances with Oral Propranolol

Bernabéu‐Wittel

Narváez-Moreno

Torre-García

et al. 2015

Pediatric Dermatology

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“…A frequently cited pharmacokinetic study of 6 pediatric subjects by Mehta et al 9 is used for justification of BID dosing of nadolol because it suggests that the long half-life of nadolol is shortened in patients ,22 months of age. After 22 months, the subjects had an elimination half-life approaching that of adults.…”

Section: Figurementioning

confidence: 99%

Death Associated With Nadolol for Infantile Hemangioma: A Case for Improving Safety

2020

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Nadolol is a β-adrenergic antagonist that has been shown to be efficacious in the treatment of infantile hemangioma. It has been suggested that this drug may have fewer side effects compared with the gold standard therapy, propranolol, because it does not exhibit membrane-stabilizing effects and has little ability to cross the blood-brain barrier. However, the pharmacokinetics and safety of nadolol in infants are not well understood, potentially making this therapy dangerous. β-adrenergic antagonist toxicity causes bradycardia, hypotension, hypoglycemia, and even death. We report a case of a 10-week-old girl who was started on nadolol for infantile hemangioma, died 7 weeks later, and was found to have an elevated postmortem cardiac blood nadolol level of 0.94 mg/L. The infant had no bowel movements for 10 days before her death, which we hypothesize contributed to nadolol toxicity. Pharmacokinetics studies show a large fraction of oral nadolol either remains in the feces unchanged or is excreted into feces via the biliary system, allowing continued absorption over time in infants who stool infrequently. Propranolol may be a safer therapy overall. Not only does it have a shorter half-life, but propranolol is hepatically metabolized and renally eliminated, allowing for less drug accumulation in healthy infants with variable stooling patterns. We suggest that if nadolol is selected for therapy, pediatricians should instruct parents to monitor their infants’ bowel movements closely and encourage early intervention in the event of decreased stooling. This intervention may greatly improve the safety of nadolol in this vulnerable patient population.

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“…T max and t 1/2 values were similar among the four isomers, however. 86,87 To support the increasing use of intravenous bblockers during cardiovascular emergency and surgery, dose proportionality of the pharmacokinetics of nadolol was evaluated after intravenous administration of 14C-nadolol at doses of 1, 2, and 4 mg to nine healthy volunteers. There were no observed differences in the excretion or pharmacokinetics of nadolol with respect to the dose administered.…”

Section: Pharmacokineticsmentioning

confidence: 99%

Chiral Cardiovascular Drugs

Ranade¹,

Somberg

2005

American Journal of Therapeutics

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Stereochemistry in drug molecules is rapidly becoming an important aspect in drug research, design, and development. Recently, individual stereoisomers of drug molecules with asymmetric centers such as fexofenadine, cetirizine, verapamil, fluoxetine, levalbutarol, and amphetamine, for example, have been separated and developed as individual drugs. These stereoisomers have different therapeutic activity, and each isomer has contributed differently with respect to its formulation's pharmacologic activity, side effects, and toxicity. The present overview discusses chirality among a select group of cardiovascular drugs, their stereochemical synthesis/preparation, isolation techniques using chiral chromatography, methods for confirmation of their enantiomeric purity, pharmacodynamics, and pharmacokinetics. Chirality has been visualized as an important factor in cardiovascular research. It is also becoming evident in other areas of therapeutics.

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Pharmacokinetics of Nadolol in Children with Supraventricular Tachycardia

Cited by 15 publications

References 14 publications

Oral Nadolol for Children with Infantile Hemangiomas and Sleep Disturbances with Oral Propranolol

Oral Nadolol for Children with Infantile Hemangiomas and Sleep Disturbances with Oral Propranolol

Death Associated With Nadolol for Infantile Hemangioma: A Case for Improving Safety

Chiral Cardiovascular Drugs

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