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Pharmacokinetics of levetiracetam in neonates with seizures

Merhar, Stephanie L., M.D.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1305030096

Abstract Details

2011, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Objective: To evaluate the pharmacokinetics and adverse events of intravenous levetiracetam in treating newborns with seizures. Study design: This was a prospective, open-label observational pharmacokinetic study in neonates = 32 weeks gestational age and = 30 days of age with seizures persisting despite treatment with phenobarbital. A loading dose of intravenous levetiracetam was given as per the prescribing physician, followed by additional doses based on clinical response. Blood samples were prospectively collected and analyzed for levetiracetam concentrations. Vital signs were monitored during levetiracetam treatment, and safety and efficacy data were collected. Results: Eighteen patients (median 39 weeks gestation and 2 postnatal days) were included. Initial loading doses ranged from 14.3-39.9 mg/kg. Median (range) clearance, volume of distribution, and elimination half-life were 1.2 ml/min/kg (0.5-2.9), 0.89 L/kg (0.4-1.3), and 8.9 hours (3.2-13.3), respectively. No adverse events related to levetiracetam were observed. Nine out of 18 patients required additional loading doses of levetiracetam to control their seizures. Conclusions: LEV clearance was lower, volume of distribution larger, and half life longer in neonates as compared to older children. Given the increased volume of distribution and lower clearance in neonates, we recommend a loading dose of at least 30 mg/kg, followed by maintenance dosing every 8-12 hours.
Paul Succop, PhD (Committee Chair)
Kurt Schibler, MD (Committee Member)
Alexander Vinks, PharmDPhD (Committee Member)
17 p.
Surgery
levetiracetam; seizure; neonate; antiepileptic; pharmacokinetics

Recommended Citations

Citations

  • Merhar, M.D., S. L. (2011). Pharmacokinetics of levetiracetam in neonates with seizures [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1305030096

    APA Style (7th edition)

  • Merhar, M.D., Stephanie. Pharmacokinetics of levetiracetam in neonates with seizures. 2011. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1305030096.

    MLA Style (8th edition)

  • Merhar, M.D., Stephanie. "Pharmacokinetics of levetiracetam in neonates with seizures." Master's thesis, University of Cincinnati, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1305030096

    Chicago Manual of Style (17th edition)

ucin1305030096
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© 2011, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.