. Author manuscript; available in PMC: 2013 Jan 23.

Published in final edited form as: J Perinatol. 2010 Dec 23;31(6):377–386. doi: 10.1038/jp.2010.146

Table 2.

Pharmacologic effects of hypothermia

Drug	Populations studied	Effects	Recommendations
Morphine^96,112	Adult, infant, animal	↓Clearance	Consider lower starting dose, Conservative dose titration
		↑Serum concentrations
		Potential for decreased efficacy
Fentanyl^97,113	Adult, animal	Drug sequestration in periphery	Consider lower starting dose
		↓Volume of distribution	Conservative dose titration
		↓Clearance	Monitor for increased response during rewarming
		↑Serum concentrations
Midazolam⁹⁵	Adult	↓Clearance	Consider lower starting dose
		↑Volume of distribution	Conservative dose titration
		↑Serum concentrations	Monitor for withdrawal or seizures during rewarming
Vecuronium^98,114	Adult, infant	↓Clearance	Use lowest effective dose
			Consider periodic discontinuation to allow for movement
Phenobarbital⁹⁹	Child, infant	↓Hepatic metabolism	Monitor serum concentrations and adjust as needed
		↑Excretion of unchanged drug
Phenytoin^102,103	Adult, infant	↓Clearance	Consider lower starting dose
		↑Serum concentrations	Monitor serum concentrations and adjust as needed
			Dosage adjustment may be needed during rewarming
Topiramate¹⁰⁴	Infant	Longer time to max concentration	Once-daily dosing recommended
		↓Clearance
		↑Serum concentrations
Gentamicin^106,115,116	Infant, animal	↓Clearance with renal dysfunction	Consider lower starting dose
		↑Serum concentrations

↓ decreased; ↑ increased.