The pharmacokinetics of intraosseous atropine in hypovolemic swine

Jonathan Yost; Phillip Baldwin; Sarah Bellenger; Freida Bradshaw; Edna Causapin; Richelle Demotica; Michael Livingston; Cynthia Lee; Brian Gegel; James Burgert; Adam Claessens; Don Johnson; Michael Loughren

doi:10.5055/ajdm.2015.0204

The pharmacokinetics of intraosseous atropine in hypovolemic swine

Jonathan Yost, Phillip Baldwin, Sarah Bellenger, Freida Bradshaw, Edna Causapin, Richelle Demotica, Michael Livingston, Cynthia Lee, Brian Gegel, James Burgert, Adam Claessens, Don Johnson, Michael Loughren

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

CONCLUSION: The IO route is an effective method of administering atropine and is comparable to the IV route even under conditions of significant hemorrhage. Therapeutic levels of atropine may be delayed and possibly difficult to obtain via IM injection in the presence of hypovolemic shock.

MAIN OUTCOME MEASUREMENTS: Pharmacokinetic parameters, maximum concentration (Cmax) and time to maximum concentration (Tmax).

RESULTS: The IV and IO groups in both the normovolemic and hypovolemic models reached peak plasma concentration immediately and had a very rapid distribution phase with no apparent absorption phase for the IO groups. Peak plasma concentration and time to reach peak concentration were both significantly lower for the IM groups. There was a significant increase in absorption time with IM administration in the hypovolemic model compared to the normovolemic model.

OBJECTIVE: Compare the pharmacokinetics of atropine administered via the intravenous (IV), intramuscular (IM), and intraosseous (IO) routes in a normovolemic and hypovolemic swine model.

DESIGN: Prospective, between subjects, experimental study.Vivarium.

SUBJECTS: Yorkshire-cross swine (N = 36).

INTERVENTION: Atropine was administered via IV, IM, or IO routes to normovolemic and hypovolemic swine. Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations.

Original language	English (US)
Pages (from-to)	217-222
Number of pages	6
Journal	American journal of disaster medicine
Volume	10
Issue number	3
DOIs	https://doi.org/10.5055/ajdm.2015.0204
State	Published - Jan 1 2015
Externally published	Yes

ASJC Scopus subject areas

Medicine(all)

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title = "The pharmacokinetics of intraosseous atropine in hypovolemic swine",

abstract = "CONCLUSION: The IO route is an effective method of administering atropine and is comparable to the IV route even under conditions of significant hemorrhage. Therapeutic levels of atropine may be delayed and possibly difficult to obtain via IM injection in the presence of hypovolemic shock.MAIN OUTCOME MEASUREMENTS: Pharmacokinetic parameters, maximum concentration (Cmax) and time to maximum concentration (Tmax).RESULTS: The IV and IO groups in both the normovolemic and hypovolemic models reached peak plasma concentration immediately and had a very rapid distribution phase with no apparent absorption phase for the IO groups. Peak plasma concentration and time to reach peak concentration were both significantly lower for the IM groups. There was a significant increase in absorption time with IM administration in the hypovolemic model compared to the normovolemic model.OBJECTIVE: Compare the pharmacokinetics of atropine administered via the intravenous (IV), intramuscular (IM), and intraosseous (IO) routes in a normovolemic and hypovolemic swine model.DESIGN: Prospective, between subjects, experimental study.Vivarium.SUBJECTS: Yorkshire-cross swine (N = 36).INTERVENTION: Atropine was administered via IV, IM, or IO routes to normovolemic and hypovolemic swine. Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations.",

author = "Jonathan Yost and Phillip Baldwin and Sarah Bellenger and Freida Bradshaw and Edna Causapin and Richelle Demotica and Michael Livingston and Cynthia Lee and Brian Gegel and James Burgert and Adam Claessens and Don Johnson and Michael Loughren",

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T1 - The pharmacokinetics of intraosseous atropine in hypovolemic swine

AU - Yost, Jonathan

AU - Baldwin, Phillip

AU - Bellenger, Sarah

AU - Bradshaw, Freida

AU - Causapin, Edna

AU - Demotica, Richelle

AU - Livingston, Michael

AU - Lee, Cynthia

AU - Gegel, Brian

AU - Burgert, James

AU - Claessens, Adam

AU - Johnson, Don

AU - Loughren, Michael

PY - 2015/1/1

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N2 - CONCLUSION: The IO route is an effective method of administering atropine and is comparable to the IV route even under conditions of significant hemorrhage. Therapeutic levels of atropine may be delayed and possibly difficult to obtain via IM injection in the presence of hypovolemic shock.MAIN OUTCOME MEASUREMENTS: Pharmacokinetic parameters, maximum concentration (Cmax) and time to maximum concentration (Tmax).RESULTS: The IV and IO groups in both the normovolemic and hypovolemic models reached peak plasma concentration immediately and had a very rapid distribution phase with no apparent absorption phase for the IO groups. Peak plasma concentration and time to reach peak concentration were both significantly lower for the IM groups. There was a significant increase in absorption time with IM administration in the hypovolemic model compared to the normovolemic model.OBJECTIVE: Compare the pharmacokinetics of atropine administered via the intravenous (IV), intramuscular (IM), and intraosseous (IO) routes in a normovolemic and hypovolemic swine model.DESIGN: Prospective, between subjects, experimental study.Vivarium.SUBJECTS: Yorkshire-cross swine (N = 36).INTERVENTION: Atropine was administered via IV, IM, or IO routes to normovolemic and hypovolemic swine. Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations.

AB - CONCLUSION: The IO route is an effective method of administering atropine and is comparable to the IV route even under conditions of significant hemorrhage. Therapeutic levels of atropine may be delayed and possibly difficult to obtain via IM injection in the presence of hypovolemic shock.MAIN OUTCOME MEASUREMENTS: Pharmacokinetic parameters, maximum concentration (Cmax) and time to maximum concentration (Tmax).RESULTS: The IV and IO groups in both the normovolemic and hypovolemic models reached peak plasma concentration immediately and had a very rapid distribution phase with no apparent absorption phase for the IO groups. Peak plasma concentration and time to reach peak concentration were both significantly lower for the IM groups. There was a significant increase in absorption time with IM administration in the hypovolemic model compared to the normovolemic model.OBJECTIVE: Compare the pharmacokinetics of atropine administered via the intravenous (IV), intramuscular (IM), and intraosseous (IO) routes in a normovolemic and hypovolemic swine model.DESIGN: Prospective, between subjects, experimental study.Vivarium.SUBJECTS: Yorkshire-cross swine (N = 36).INTERVENTION: Atropine was administered via IV, IM, or IO routes to normovolemic and hypovolemic swine. Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations.

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The pharmacokinetics of intraosseous atropine in hypovolemic swine

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