The Pharmacokinetics of Methohexital in Young and Elderly Subjects

Ghoneim, Mohammed M.; Chiang, Chao-Kuo; Schoenwald, Ronald D.; Lilburn, J.K.; Dhanaraj, J.

doi:10.1111/j.1399-6576.1985.tb02237.x

Cited by 12 publications

(3 citation statements)

References 19 publications

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“…The pharmacokinetics of methohexitone in adults has been investigated after i.v. bolus in surgical patients [4,5] and volunteers [5] and with short-term infusions in volunteers [6]; fairly consistent results have been obtained. However, studies with hexobarbitone [7] suggest that pharmacokinetic data from volunteers or "normal" surgical patients may not apply to intensive care patients, in whom physiological functions are altered by factors such as trauma, infection, fever and multi-drug treatment.…”

supporting

confidence: 69%

“…The mean clearance of methohexitone in our patients (16.3 ml min" 1 kg" 1 ) was greater than in young volunteers (12.1 ml min" 1 kg" 1 ) [6], surgical patients (10.9 ml min" 1 kg" 1 ) [4]; 8.2-9.3 ml min" 1 kg" 1 [5]) or in elderly postoperative patients (9.3-9.8 ml min" 1 kg" 1 ) [3]. This increase in clearance may be a result of several factors, for example fever, changes in liver blood flow or induction of hepatic mixed function oxidases.…”

Section: Discussionmentioning

confidence: 85%

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Pharmacokinetics and Clinical Experience of 20-H Infusions of Methohexitone in Intensive Care Patients With Postoperative Pyrexia

Redke

Björkman

Rosberg

1991

British Journal of Anaesthesia

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We have studied the pharmacokinetics of 20-h infusions of methohexitone in young patients with postoperative fever undergoing artificial ventilation of the lungs. The infusion rate was adjusted so that patients were unresponsive to vocal stimulation but reacted to tracheal suction. The mean steady state concentration of methohexitone required was 2.6 mg litre-1 (unbound 0.53 mg litre-1). The mean (SD) total clearance of methohexitone was 16.3 (4.2) ml min-1 kg-1, which is greater than that for volunteers or normal surgical patients. The unbound clearance correlated positively with body temperature during the infusion (r = 0.796, P = 0.017). The terminal half-life of methohexitone was 6.3 (3.8) h and that of the 4'-hydroxy metabolite 5.8 (2.1) h. There were no marked haemodynamic effects of the infusion, and no excessive sedation after the infusion. However, the clearance of methohexitone was high and variable, possibly as a direct effect of postoperative fever. Consequently, the need for individual titration of the rate of infusion is emphasized.

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supporting

confidence: 69%

Section: Discussionmentioning

confidence: 85%

Pharmacokinetics and Clinical Experience of 20-H Infusions of Methohexitone in Intensive Care Patients With Postoperative Pyrexia

Redke

Björkman

Rosberg

1991

British Journal of Anaesthesia

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“…In elderly patients there is a tendency for total body water, cardiac output and hepatic blood flow to be lower than in young patients [1]. Pharmacokinetic studies of thiopentone [2,3] methohexitone [4] and etomidate [5] have shown significant changes with ageing. We have compared the pharmacokinetics of propofol (2,6 diisopropylphenol) in elderly and young patients.…”

mentioning

confidence: 99%

Pharmacokinetics of Propofol (Diprivan) in Elderly Patients

Kirkpatrick¹,

Cockshott²,

Douglas³

et al. 1988

British Journal of Anaesthesia

281

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The pharmacokinetics of propofol (2,6 diisopropylphenol) were compared in 12 patients aged 65-80 yr and 12 patients aged 18-35 yr. After premedication with papaveretum i.m., anaesthesia was induced with propofol 2.0 mg kg-1 in the elderly and 2.5 mg kg-1 in the younger patients. Alcuronium 12-20 mg was then given and the patient's lungs ventilated with halothane and nitrous oxide in oxygen. Blood was taken after various time intervals up to 24 h for the measurement of propofol concentrations by HPLC and for the estimation of propofol protein binding. The mean blood propofol concentration was generally higher in the elderly group, but this difference was only significant at 2 min after induction. The clearance of propofol was significantly lower in the elderly (1.44 +/- 0.10 (SE) litre min-1) than in the younger patients (1.79 +/- 0.12 litre min-1). The volume of the central compartment in the elderly patients was significantly smaller (19.6 +/- 5.2 litre) than that in the young (26.3 +/- 2.9 litre). There was no difference in the volume of distribution at equilibrium (1608 +/- 246 litre in the elderly and 1757 +/- 360 litre in the young), in the volume of distribution at steady state (691 +/- 139 litre in the elderly and 771 +/- 236 litre in the young) or in the half-lives of distribution and elimination. The plasma protein binding of propofol was similar in both groups and showed no trend with time after dose.

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Pharmakokinetik

Taeger¹

1991

Der Geriatrische Patient in Der Anaesthesie

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The Pharmacokinetics of Methohexital in Young and Elderly Subjects

Cited by 12 publications

References 19 publications

Pharmacokinetics and Clinical Experience of 20-H Infusions of Methohexitone in Intensive Care Patients With Postoperative Pyrexia

Pharmacokinetics and Clinical Experience of 20-H Infusions of Methohexitone in Intensive Care Patients With Postoperative Pyrexia

Pharmacokinetics of Propofol (Diprivan) in Elderly Patients

Pharmakokinetik

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