Pharmacokinetics of intravenous dexmedetomidine in children under 11 yr of age

Abstract

To reach a certain plasma concentration, children younger than 2 yr of age evidently need larger initial doses of dexmedetomidine than the older children, as young children have a larger volume of distribution of the drug than older children and adults. Since the total plasma clearance of dexmedetomidine is independent of age, similar rates of infusion can be used in younger and older children to maintain a steady-state concentration of dexmedetomidine in plasma.

Dexmedetomidine: pediatric pharmacology, clinical uses and safety

“…Four pharmacokinetic studies of dexmedetomidine administered to children reported values similar to those in adults: V d 1.5 --2.2 l/kg, Cl 0.56 --1 l/kg/h and t 1/2b 1.6 --2.7 h [29][30][31][32]. A pooled population pharmacokinetic analysis of the four studies cited above was best described using an allometrically-scaled twocompartment model: V d 125.3 l/70 kg (1.8 l/kg) and Cl 42.1 l/h/70 kg (0.6 l/kg/h) [33].…”

“…Evaluation of the effects of dexmedetomidine on serum glucose levels shows no change in serum glucose while compared to pre-and post-infusion measurements [41]. Likewise, dexmedetomidine is not associated with an increased incidence of gastrointestinal side effects including emesis, ileus or elevated hepatic transaminase [20,21,32,38,43,65,78]. There is one case report of suspected drug fever in the adult literature [79].…”

Spinal Anaesthetic Management in Paediatric Surgery

“…In addition to the previously mentioned agents, dexmedetomidine (a potent, selective alpha-2 adrenoceptor agonist) may also be used. Dexmedetomidine provides natural sleep, anxiolysis and analgesia [50].…”

Dexmedetomidina: papel atual em anestesia e cuidados intensivos

“…and adults to effect a steady state plasma concentration 14 . However, in patients aged ≥ 65 years, a greater incidence of hypotension and bradycardia was reported; therefore, a dose reduction in this population may be warranted 12 .…”

“…However, in patients aged ≥ 65 years, a greater incidence of hypotension and bradycardia was reported; therefore, a dose reduction in this population may be warranted 12 . In children younger than 2 years of age, the volume of distribution at steady state is increased, suggesting that higher doses are required to achieve steady state; but t ½ β is prolonged, which may result in increased drug accumulation with time 14 .…”