Single enteral loading dose of phenobarbital for achieving its therapeutic serum levels in neonates.
OBJECTIVE
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 microg/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.


CONCLUSIONS
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.
Turhan
Ali H
AH
Hospital of Mersin University School of Medicine, Department of Pediatrics, 33079 Mersin, Turkey. alihaydarturhan@gmail.com
Atici
Aytug
A
Okuyaz
Cetin
C
Uysal
Sercan
S
D000927:Anticonvulsants / Q000008:administration & dosage* / Q000097:blood* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004750:Enteral Nutrition; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010634:Phenobarbital / Q000008:administration & dosage* / Q000097:blood* / Q000494:pharmacology; D014421:Turkey
D000927:Anticonvulsants; D010634:Phenobarbital