title: Pentobarbital pharmacokinetics in patients with severe head injury.
abstract: Intravenous administration of high-dose pentobarbital has been proposed as a treatment for elevated intracranial pressure refractory to other measures in brain-injured patients. The purpose of this clinical study was to examine the pharmacokinetics of high-dose continuous intravenous infusion of pentobarbital in this critical care setting. Six patients received a 25-34 mg/kg intravenous loading dose followed by a 1-3 mg/kg/h continuous infusion for 61-190 hours. Dosing rates were adjusted based on the patient's clinical status. The mean clearance was 0.72 ml/min/kg, with a volume of distribution (Vd) of 1.03 L/kg and a terminal half-life of 19.1 h. Considerable variation in individual patient parameters was observed. In addition, a change in clearance was suggested in patients requiring a longer infusion duration.
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007427:Intracranial Pressure / Q000187:drug effects*; D007700:Kinetics; D008297:Male; D008657:Metabolic Clearance Rate; D008991:Monitoring, Physiologic; D010424:Pentobarbital / Q000008:administration & dosage / Q000378:metabolism*; D011559:Pseudotumor Cerebri / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D010424:Pentobarbital