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  • Title: Indomethacin and the preterm infant with a patent ductus arteriosus: relationship between plasma concentration and ductus closure.
    Author: Friedman CA, Parks BR, Rawson JE, Serwer GA, Anderson PA.
    Journal: Dev Pharmacol Ther; 1982; 4(1-2):37-46. PubMed ID: 7117089.
    Abstract:
    The relationship of indomethacin pharmacokinetics to clinical and echocardiographic evidence of closure of the patient ductus arteriosus (PDA) is described in 9 preterm infants. PDA closures occurred in 4 infants when peak indomethacin plasma concentrations were 0.71-1.10 micrograms/ml, mean 0.93 +/- 0.16 microgram/ml. With partial or no PDA response to oral treatment, the peak concentrations were 0.20-0.69 microgram/ml, mean 0.57 +/- 0.08 microgram/ml, p less than 0.01. The left atrial size in the study infants correlated inversely with the indomethacin peak concentrations, r = 0.75. The plasma apparent terminal half-life correlated with postnatal age, r = 0.75. All patients with peak concentrations greater than 0.50 microgram/ml had transient oliguria. This study suggests that a minimum indomethacin concentration may be needed to promote PDA constriction.
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