A literature review of the pharmacokinetics and pharmacodynamics of dobutamine in neonates

Mahoney, Liam, Shah, Geetika, Crook, David, Rojas-Anaya, Hector and Rabe, Heike (2016) A literature review of the pharmacokinetics and pharmacodynamics of dobutamine in neonates. Pediatric Cardiology, 37 (1). pp. 14-23. ISSN 0172-0643

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Abstract

Since its discovery in 1975 dobutamine has been used off-label for treating hemodynamic insufficiency in newborns and children. We present a structured literature review of pharmacokinetic and pharmacodynamic data for dobutamine in the pediatric population. Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria. Where possible, results for the pharmacodynamic and pharmacokinetic effect of dobutamine were reported as pooled data. Fortysix papers met the inclusion criteria. With regard to pharmacodynamic data a number of studies reported significant increases in a number of clinical parameters such as heart rate, blood pressure, cardiac output across a wide range of pediatric populations. With regard to pharmacokinetic data studies reported that the infusion rate was positively correlated to plasma dobutamine concentration. There was great variability with regard to dobutamine clearance between individuals and as to whether it followed first- or zero-order elimination kinetics. While the pharmacodynamic effects of dobutamine appear to reflect the pharmacological
profile of the drug, the pharmacokinetic data are difficult to interpret due to inhomogeneity between study populations ages, comorbidities, dobutamine dosages and methodologies. High-quality prospective pharmacokinetic and pharmacodynamic data especially in newborns are urgently required prior to a large randomized study.

Item Type: Article
Keywords: Dobutamine, Neonate, Hypotension, Pediatric, Pharmacodynamic, Pharmacokinetic
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine
R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ0052 Therapeutics
R Medicine > RJ Pediatrics > RJ0250 Premature infants
R Medicine > RJ Pediatrics > RJ0251 Newborn infants Including physiology, care, treatment, diseases
Depositing User: Katie Isaac
Date Deposited: 10 Sep 2015 13:52
Last Modified: 08 Mar 2017 06:30
URI: http://sro.sussex.ac.uk/id/eprint/56634

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