Original scientific paper
Single Enteral Loading Dose of Phenobarbital for Achieving Its Therapeutic Serum Levels in Neonates
Ali H. Turhan
orcid.org/0000-0003-4018-1179
; Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
Aytug Atici
; Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
Cetin Okuyaz
; Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
Sercan Uysal
; Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
Abstract
Aim To investigate whether therapeutic serum drug levels
may be achieved with a single enteral loading dose of
phenobarbital.
Methods The study was performed at the Mersin University
Hospital in Turkey between April 2004 and August 2006,
and included 29 newborn babies with seizure. After the
acute treatment of the seizure with midazolam at a dose of
0.1 mg/kg, phenobarbital was administered by orogastric
route at a loading dose of 20 mg/kg. Serum phenobarbital
concentrations were measured at 0.5, 3, 6, and 12 hours
after the loading. Serum phenobarbital levels between 10-
30 μg/mL were considered as the therapeutic range.
Results The serum phenobarbital levels reached therapeutic
values in 9 (31%), 19 (66%), 21 (72%), and 23 (79%)
patients at 0.5, 3, 6, and 12 hours after loading, respectively,
while they did not reach therapeutic values in 6 patients
(21%) after 12 hours. Four of the patients in whom there
was no increase in serum phenobarbital levels had hypoxic-
ischemic encephalopathy.
Conclusion Enteral loading of phenobarbital can achieve
therapeutic serum levels in the large majority of newborn
babies with seizure and may be safely used in babies with
the intact gastrointestinal tract.
Keywords
Phenobarbital; newborn; seizure; treatment
Hrčak ID:
55657
URI
Publication date:
15.6.2010.
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