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The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis.
- Source :
-
Paediatric anaesthesia [Paediatr Anaesth] 2018 Feb; Vol. 28 (2), pp. 80-86. Date of Electronic Publication: 2017 Dec 21. - Publication Year :
- 2018
-
Abstract
- Background: Intravenous ketorolac is commonly administered to children for the control of postoperative pain. An effect site EC <subscript>50</subscript> for analgesia of 0.37 mg <superscript>.</superscript> L <superscript>-1</superscript> is described in adults.<br />Aims: The aim of this study was to review age- and weight-related effects on ketorolac pharmacokinetic parameters in children and current dosing schedules.<br />Methods: Pooled intravenous ketorolac (0.5 mg <superscript>.</superscript> kg <superscript>-1</superscript> ) concentration-time data in children aged 2 months to 16 years were analyzed using nonlinear mixed-effects models. Allometry was used to scale to a 70 kg person.<br />Results: There were 64 children aged 2 months to 16 years (641 plasma concentrations) available for analysis. A two-compartment mammillary model was used to describe pharmacokinetics. Clearance was 2.53 (CV 45.9%) L <superscript>.</superscript> h <superscript>-1.</superscript> 70 kg <superscript>-1</superscript> and intercompartment clearance was 4.43 (CV 95.6%) L <superscript>.</superscript> h <superscript>-1.</superscript> 70 kg <superscript>-1</superscript> . Both central (V1) and peripheral (V2) volumes of distribution decreased with age over the first few years of postnatal life to reach V1 6.89 (CV 30.3%) L <superscript>.</superscript> 70 kg <superscript>-1</superscript> and V2 5.53 (CV 47.6%) L <superscript>.</superscript> 70 kg <superscript>-1</superscript> .<br />Conclusion: Clearance, expressed as L <superscript>.</superscript> h <superscript>-1.</superscript> kg <superscript>-1</superscript> , decreased with age from infancy. A dosing regimen of 0.5 mg <superscript>.</superscript> kg <superscript>-1</superscript> every 6 hours maintains a trough concentration larger than 0.37 mg <superscript>.</superscript> L <superscript>-1</superscript> in children 9 months to 16 years of age. This dosing regimen is consistent with current recommendations.<br /> (© 2017 John Wiley & Sons Ltd.)
- Subjects :
- Administration, Intravenous
Adolescent
Age Factors
Anti-Inflammatory Agents, Non-Steroidal administration & dosage
Child
Child, Preschool
Female
Humans
Infant
Ketorolac administration & dosage
Male
Anti-Inflammatory Agents, Non-Steroidal pharmacokinetics
Ketorolac pharmacokinetics
Pain, Postoperative drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1460-9592
- Volume :
- 28
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Paediatric anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 29266539
- Full Text :
- https://doi.org/10.1111/pan.13302