EFFECTS OF PORTO-SYSTEMIC ANASTOMOSES IN CHILDHOOD ON PHARMACOKINETICS OR PROPRANOLOL

  • 1 January 1981
    • journal article
    • research article
    • Vol. 111  (29) , 1088-1093
Abstract
Kinetics of propranolol after oral administration were investigated in 9 children aged 5-11 yr with intact liver function who underwent porto-systemic anastomosis surgery for pylethrombosis and in a 16-yr-old boy with a Warren shunt. Bioavailability of the drug increased by twice the values measured in physiologic liver blood flow; elimination half-life doubled. These alterations must be taken into consideration in medication, e.g., extreme care must be exercised in the oral administration of first pass drugs in porto-systemic shunt patients and it is recommended that the initial dose should be at the level of intravenous administration. The reduced rate of elimination should be taken into account in the case of drugs whose elimination depends on liver blood flow.