Propranolol kinetics in plasma from severely burned adults

Ashley Guillory, David Herndon, Michael Silva, Clark R. Andersen, Erge Edgu-Fry, Oscar Suman, Celeste Finnerty

Research output: Contribution to journalArticle

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Abstract

Objectives: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. Methods: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n = 10) or following one of three dosing strategies: Q6 (n = 4), Q8 (n = 6), and Q24 (n = 6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. Results: Heart rate was 86. ±. 2 bpm for Q6, 93. ±. 3 bpm for Q8, and 90. ±. 4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p = 0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p = 0.02). Conclusions: Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.

Original languageEnglish (US)
JournalBurns
DOIs
StateAccepted/In press - 2016

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Propranolol
Heart Rate
Research Ethics Committees
Body Surface Area
Burns
Analysis of Variance
Placebos
Blood Pressure

Keywords

  • Adult
  • Burns
  • Heart rate
  • β-Adrenergic receptor antagonists

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Propranolol kinetics in plasma from severely burned adults. / Guillory, Ashley; Herndon, David; Silva, Michael; Andersen, Clark R.; Edgu-Fry, Erge; Suman, Oscar; Finnerty, Celeste.

In: Burns, 2016.

Research output: Contribution to journalArticle

Guillory, Ashley ; Herndon, David ; Silva, Michael ; Andersen, Clark R. ; Edgu-Fry, Erge ; Suman, Oscar ; Finnerty, Celeste. / Propranolol kinetics in plasma from severely burned adults. In: Burns. 2016.
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AU - Herndon, David

AU - Silva, Michael

AU - Andersen, Clark R.

AU - Edgu-Fry, Erge

AU - Suman, Oscar

AU - Finnerty, Celeste

PY - 2016

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N2 - Objectives: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. Methods: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n = 10) or following one of three dosing strategies: Q6 (n = 4), Q8 (n = 6), and Q24 (n = 6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. Results: Heart rate was 86. ±. 2 bpm for Q6, 93. ±. 3 bpm for Q8, and 90. ±. 4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p = 0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p = 0.02). Conclusions: Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.

AB - Objectives: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. Methods: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n = 10) or following one of three dosing strategies: Q6 (n = 4), Q8 (n = 6), and Q24 (n = 6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. Results: Heart rate was 86. ±. 2 bpm for Q6, 93. ±. 3 bpm for Q8, and 90. ±. 4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p = 0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p = 0.02). Conclusions: Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.

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