Pharmacokinetics in children

Kadar et al. have carried out research in a very small group of children with severe brain damage, looking at the metabolization of intravenously administered isoprenaline. This means that there will be a two-phase elimination. A rapid phase with elimination half-lives of 2.5 to 5 minutes is followed by a slower second phase of 3 to 7 hours. There is also rapid metabolization: after 15 to 30 minutes, less than 10% can be recovered unchanged in the plasma. The excretion pathway appears to be primarily renal.

Studies by Reyes et al. show that the pharmacokinetics are first-order, with large inter-individual variability. A distinction is made between a cardiac group and a pulmonary group. The clearance varied between 33.2±4.9 ml/kg/min and 48.4±7.3 ml/kg/min between the two different groups. The distribution half-life was 4.2±1.5 minutes and the volume of distribution was 216±57 ml/kg.
 

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Renal impaiment in children > 3 months

No information available on dose adjustment in renal impairment.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Hypotension, tachycardia sometimes with myocardial ischemia as a result.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Administer while monitoring the haemodynamic parameters under the supervision of an intensive care specialist, cardiologist or neonatologist (sufficient specialization required to be able to intervene in the event of respiratory depression)

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

• CARDIOVASCULAR SYSTEM
• CARDIAC THERAPY

CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

References

1. Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2008
2. Reyes G, et al, The pharmacokinetics of isoproterenol in critically ill pediatric patients, J Clin Pharmacol., 1993, Jan;33(1), 29-34
3. Kadar D, et al, Isoproterenol metabolism in children after intravenous administration., Clin Pharmacol Ther., 1974, Nov;16(5 Part 1), 789-95

Changes

Therapeutic Drug Monitoring

Overdose