Intravenous valproate dosing in neonates

被引:11
作者
Alfonso, I
Alvarez, LA
Gilman, J
Dunoyer, C
Yelin, K
Papazian, O
机构
[1] Univ Miami, Dept Neurol, Childrens Hosp, Div Neonatal Neurol,Dept Neurol, Miami, FL 33152 USA
[2] Childrens Hosp, Dept Neurol, Miami, FL USA
[3] Childrens Hosp, Dept Neurosci, Miami, FL USA
[4] Hosp Gen Agudos C Durand, Dept Pediat, Buenos Aires, DF, Argentina
关键词
D O I
10.1177/088307380001501216
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The loading dosage of intravenous valproate required to achieve a desired serum concentration in neonates is not known. Two neonates with seizures received loading doses of intravenous valproate over 30 minutes. Serum valproate concentrations were measured 45 minutes and 3 hours after initiation of the infusion. Both neonates had received phenobarbital and phenytoin before the loading infusions. In the first patient, a loading dose of intravenous valproate of 10 mg/kg increased the 45-minute postinfusion serum valproate concentration to 41 mug/mL with a 3-hour postin-fusion serum valproate concentration of 33 mug/mL. In the second patient, a loading dose of 25 mg/kg increased the 45-minute postinfusion serum valproic acid concentration to 100 mug/mL with a 3-hour postinfusion serum valproic acid concentration of 78 mug/mL,. We found that each I mg/kg of intravenous valproate increased the 45-minute and 3-hour postinfusion serum valproic acid concentrations by approximately 4 mug/mL and 3 mug/mL, respectively. We suggest that these figures be used to calculate the desirable loading dose of intravenous valproate in neonates until larger studies are conducted. The volume of distribution and the serum clearance of valproate were approximately 0.245 L/kg and 25 mL/h/kg, respectively.
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收藏
页码:827 / 829
页数:3
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