Abstract
Pain in infants is an important problem. Little is known about pharmacokinetics (PK) and pharmacodynamics (PD) of the analgesic APAP in preterm infants. PK and PD were studied in 15 preterm infants (28-32 weeks gestation, mean ±SD 30.3 ± 1 wk, birthweight 1145±239 g) after a single dose (20mg/kg) of rectally administered APAP. Pain was assessed with a modified painscore. We measured peak plasma concentration(Cm), time to reach Cm(Tm), T1/2, time to estimated therapeutic level(10-20 mg/l)(T1), and excretion in urine (48 h). No changes were noted in heart and respiratory rate during the study. Data are presented as mean ± SD or median + range.
Therapeutic levels were reached in 11 infants (73%) and remained high for more than 8 hours in individual infants. There appeared to be good analgesia even at levels below 10 mg/l. Due to long Tm values for T1/2 were not reliable. Over 80 % was excreted in urine as APAP-sulfate. We conclude that 1) APAP in preterms appears to be safe and effective, 2) a higher dose might be needed to shorten T, interval, and 3) dose interval should be more than 8 hours in case of multiple doses.
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Van Iingen, R., Deinum, H., Quak, C. et al. 130 PHARMACOKINETICS AND DYNAMICS OF RECTALLY ADMINISTERED SINGLE DOSE ACETAMINOPHEN (APAP) IN PRETERM INFANTS. Pediatr Res 36, 24 (1994). https://doi.org/10.1203/00006450-199407000-00130
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DOI: https://doi.org/10.1203/00006450-199407000-00130