Pharmacokinetics and clinical effects of sublingual triazolam in pediatricdental patients

The purpose of this investigation was to describe the pharmacokinetics of s ublingual triazolam in children. Nine healthy children (64-98 months old) r eceived 0.25 or 0.375 mg of sublingual triazolam before dental treatment. P lasma triazolam concentrations were measured by gas chromatography/mass spe ctrometry and analyzed by noncompartmental methods. The peak concentration was 4.9 +/- 2.0 ng/mL (mean +/- SD), time to peak was 75 +/- 32 minutes, th e elimination half-life was 91 +/- 32 minutes, and apparent clearance was 1 7.6 +/- 8.8 mL.kg(-1).min(-1). Children were tested for gait ataxia, amnesi a, and diplopia during a screening session and again after triazolam, Ninet y minutes after drug administration, seven of nine children demonstrated at axia, and three of nine demonstrated amnesia. Peak triazolam concentrations were similar in children with or without ataxia, but they were significant ly higher in children with amnesia compared with those without amnesia. Six children demonstrated diplopia 30 and 120 minutes after triazolam; however , peak triazolam concentrations were similar in both groups. Sublingual adm inistration was an acceptable alternative route of triazolam delivery in ch ildren.