Answers -- Phenobarbital Case #1


Will concentration go higher?
One cannot tell from the two points given. It is possible that the peak occurred earlier than the measured point and it is possible that it may be later. However, noting that over the entire dose interval, the change in concentration was small, it is unlikely that a peak would be significantly higher, if this is not the peak.

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Will concentration go lower?
The simple answer is that the "trough" should be the lowest concentration of the dose interval. If the drug were given intravenously, there is no doubt about this statement. If the drug is given orally, as is phenobarbital, then it is quitely likely that the concentration will drop a bit more before a significant amount of the drug is absorbed. Gastric emptying time, dissolution rates, and other factors can contribute to delayed absorption of drug.

However, in clinical pharmacokinetics, it is generally assumed that the trough represents the lowest and most reliable estimate of drug concentration.

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Is the phenobarbital eliminated rapidly or slowly?
It is eliminated very slowly. In a "typical" animal, it takes 53 hours for the concentration to decrease by half. The concentration of most drugs we use in therapy will decrease by half in much shorter time intervals. For example, the concentration of penicillin G given intravenously will decrease by half in less than one hour!

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Last modified: 8/19/96 glc