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Blood Level of Phenobarbital in Treatment of Seizure After Neonatal Asphyxia.

Journal of the Korean Pediatric Society 1989;32(9):1265-1272.
Published online September 30, 1989.
Blood Level of Phenobarbital in Treatment of Seizure After Neonatal Asphyxia.
Ji Yean Lee, Heng Mi Kim, Doo Hong Ahn
Department of Pediatrics, Kyungpook National University, School of Medicine, Taegu, Korea
신생아 가사후 경련시의 Phenobarbital 부하에 따른 혈중농도의 변화
이지연, 김행미, 안두홍
경북대학교 의과대학 소아과학교실
Received: 2 March 1989   • Accepted: 20 April 1989
Abstract
In this study, we attempted to determine an optimal first dose of phenobarbital for the treatment of seizures in the asphyxiated full term neonates. Blood samples were obtained 2 to 48 hours after the administration of final effective loading dose and plasma levels were determined by the EMIT system. Four groups of neonates were studied. Six neonates (Group 1) received an intravenous loading dose of 10 mg/kg a day followed by a maintenance dose of 5 mg/kg a day. Seven neonates (Group 2) received 15 mg/kg a day followed by 4 mg/kg a day, 5 neonates (Group 3) received 20 mg/kg a day followed by 3.4 mg/kg a day and 2 neonates (Group 4) received 30 mg/kg a day followed by 4 mg/kg. Following intravenous administrations of 10 mg/kg, 15 mg/kg, 20 mg/kg and 30 mg/kg, levels of 5. 4±1.8jtzg/ml, 25.0±8.2 ^g/ml, 27.5± 5.8 #g/ml and 50.1 ±1.1 //g/ml were achieved 2 hours after injection respectively. Increasing serum levels were observed in group 1 cases. In 13 of the neonates the plasma levels allowed attemps to evaluate the anti-convulsive effect of phenobarbital. In 9 cases (64.2%) who phenobarbital seemed to be effective, the minimal level of phenobarbital concentration when seizures ceased was 13.7 /zg/ml and average concentration was 28. 4±10.0 //g/ml.
Key Words: Neonate, Seizures, Phenobarbital


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