The effects of acute changes in renal function on the pharmacokinetics of midazolam during long-term infusion in ICU patients.

摘要: This study investigated the pharmacokinetics of midazolam and its main metabolite, 1-hydroxymethylmidazolam glucoronide, during long-term i.v. infusion in 39 mechanically ventilated ICU patients whom 6 were acute renal failure (ARF). The mean rate was similar (9.4 vs 8.7 mg/h) control those with ARF. clearance glucuronide much lower ARF group than (3.9 136 ml/min). Consequently, plasma elimination half-life after discontinuation also greatly prolonged, but this shouldn't cause very prolonged sedative effects since metabolite is less active parent drug. However, itself significantly longer (13.2 7.6 h). Apparently, caused by a combination slightly total higher volume distribution. Therefore, regular reassessment degree sedation appropriate adaptation are recommended