Influence of cardiac output on dexmedetomidine pharmacokinetics.
Dexmedetomidine, a highly selective alpha(2)-adrenoceptor agonist, reduces the requirements for anesthetic, analgesic, sedative, and hypnotic drugs. Dexmedetomidine pharmacokinetics were characterized in healthy subjects after intravenous administration by means of a computer-controlled infusion pump. A series of seven stepwise increasing pseudo-steady-state plasma concentrations were targeted. The influence of cardiac output on the pharmacokinetics was investigated by use of a compartmental modeling approach in which the elimination clearance was characterized as being either cardiac output independent or dependent. At dexmedetomidine concentrations of 0, 0.6, and 1.2 ng/mL, mean (SD) estimated cardiac outputs were 5. 6 (0.85), 5.1 (0.67), and 4.5 (0.83) L/min, and mean (SD) clearances were 40 (10), 38 (9.0), and 35 (8.5) L/h, respectively. Dexmedetomidine V(SS) and elimination half-life were 72 (19) L and 1. 9 (0.62) h, respectively. The approximately 3 to 19% decrease in cardiac output observed within the anticipated therapeutic range of 0.3 to 1.2 ng/mL was similar to that observed for clonidine. The decrease in cardiac output with increasing plasma concentrations of dexmedetomidine resulted in a corresponding decrease in drug elimination clearance of < or =12% within the therapeutic range; however, this decrease in dexmedetomidine clearance is likely not clinically relevant.
Dutta
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Clinical Pharmacokinetics and Toxicokinetics Department, Abbott Laboratories, Abbott Park, IL 60064-6104, USA. Sandeep.Dutta@Abbott.com
Lal
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Karol
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Cohen
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Ebert
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D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000493:pharmacokinetics*; D000328:Adult; D002302:Cardiac Output / Q000502:physiology*; D020927:Dexmedetomidine / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged
D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine