Abstract
Successful closure of patent ductus arteriosus(PDA)with Indomethacin(Ind.)has been previously described.Since failure to close PDA with Ind. has also been noted.We examined plasma concentrations of Ind. in 3 premature infants with patent ductus arteriosus(PDA)following oral administration.All had a clinically large PDA and echocardiographic evidence of LA/AO ratio of >1.3. Ind. was administered through nasogastric tube 0.1 mg/kg in one infant and 0.2 mg/kg in 2 infants q.8.h.Blood was obtained by heel stick at 15,30,mins. and 1,2,4,6,8,and 24 hr. intervals. Plasma levels of Ind. was assayed using a gas liquid chromatography method,following derivitization with triethylanilinium hydrochloride.Daily serum levels of creatinine and platelet count were also followed.Results are shown in the table below.
Pt. #1 died before the effect of Ind. treatment could be assessed.Pt. #2 had a good response.Pt. #3 had two trials(3a,3b) of Ind. therapy.In this infant LA/AO remained high although there was clinical improvement following Ind.Maximal absorption occurred within 2 hrs. of administration.Marked variation between subjects was observed in peak concentration.Elimination half life was considerably longer than that reported in adults.
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Evans, M., Bhat, R., Vadepalli, M. et al. 245 DISPOSITION OF INDOMETHACIN IN PREMATURE INFANTS. Pediatr Res 12 (Suppl 4), 404 (1978). https://doi.org/10.1203/00006450-197804001-00250
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DOI: https://doi.org/10.1203/00006450-197804001-00250