The role of pharmacokinetics and pharmacodynamics in clinical anaesthesia practice.
Aged
Analgesics, Opioid
/ pharmacokinetics
Anesthesia
Anesthetics
/ pharmacokinetics
Anesthetics, Intravenous
Artificial Intelligence
Bayes Theorem
Child
Dose-Response Relationship, Drug
Humans
Hypnotics and Sedatives
/ pharmacokinetics
Models, Biological
Propofol
/ pharmacokinetics
Remifentanil
/ pharmacokinetics
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
pubmed:
13
6
2020
medline:
9
7
2020
entrez:
13
6
2020
Statut:
ppublish
Résumé
Growing concerns about the environmental effects of volatile anaesthetics are likely to lead to increased use of intravenous anaesthetic drugs. Pharmacokinetic/pharmacodynamic (PKPD) models can increase the accuracy of intravenous drug titration, especially in populations that differ from the 'average.' However, with a growing number of PKPD models, and other technology available to date, it can be hard to see the wood for the trees. This review attempts to guide the reader through the PKPD jungle. General purpose PKPD models for propofol and remifentanil designed to apply to a broader population, including children, the elderly and the obese, reduce the need for population-specific models. PKPD models for drugs such as dexmedetomidine and antimicrobial agents may be useful for procedural sedation or in the ICU. Technological advances such as Bayesian model adjustment based on point-of-care plasma concentration measurements, closed-loop drug delivery and artificial intelligence may improve the ease of use of the anaesthetic drugs and increase the accuracy of titration. Newer and more complex modelling techniques and technological advancements can help to deliver anaesthetic drugs, sedatives and other drugs in a more stable and thereby safer way.
Identifiants
pubmed: 32530894
doi: 10.1097/ACO.0000000000000881
pii: 00001503-202008000-00003
doi:
Substances chimiques
Analgesics, Opioid
0
Anesthetics
0
Anesthetics, Intravenous
0
Hypnotics and Sedatives
0
Remifentanil
P10582JYYK
Propofol
YI7VU623SF
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
483-489Références
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