Wermeling D P, Blouin R A, Porter W H, Rapp R P, Tibbs P A
Drug Intell Clin Pharm. 1987 May;21(5):459-63. doi: 10.1177/106002808702100517.
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.
对于脑损伤患者中其他措施难以治疗的颅内压升高，已有人提出静脉注射大剂量戊巴比妥作为一种治疗方法。这项临床研究的目的是在这种重症监护环境中研究大剂量持续静脉输注戊巴比妥的药代动力学。6名患者接受了25 - 34mg/kg的静脉负荷剂量，随后以1 - 3mg/kg/h的速度持续输注61 - 190小时。给药速率根据患者的临床状况进行调整。平均清除率为0.72ml/min/kg，分布容积（Vd）为1.03L/kg，终末半衰期为19.1小时。观察到个体患者参数存在相当大的差异。此外，对于需要更长输注时间的患者，提示清除率有变化。
