Pyridostigmine kinetics with and without renal function

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Abstract
Pyridostigmine kinetics were examined under conditions of clinical use as an antagonist of nondepolarizing neuromuscular blockade in anesthetized patients with and without renal function. Pyridostigmine serum levels were assayed by GLC, and data were fitted to a 2-compartment kinetic model. Pyridostigmine kinetics following renal transplantation (no. 5) were not different from those in patients with normal renal function. Renal function (no. = 5) elimination half-life increased from 112 .+-. 12 min (.hivin.x [mean] .+-. SD) to 379 .+-. 162 min and serum clearance decreased from 9 .+-. 2 ml/kg per min to 2 .+-. 0.6 ml/kg per min in anephric patients (no. = 4). Renal function accounts for 75% of pyridostigmine clearance.