Abstract
The science or art of pharmacokinetic analysis embodies the description of the time-dependant concentration changes of a drug. Pharmacokinetic models may be used to predict the behaviour of the drug in individuals, preferably under various circumstances. In the practice of anaesthesia pharmacokinetics can be studied on the work floor. Differences in pharmacokinetics between individuals are observed on a daily basis. Factors responsible for the interindividual variability are being studied extensively and more data become available in time. From these data the significance of demographic factors such as age and gender become increasingly apparent. Other factors like weight or lean body mass may be substitute parameters for physiologically based variations in pathways of distribution and elimination. Obesity e.g. may be considered as a disproportionate increase in adipose tissue mass. Peripheral blood flow must increase to supply this extra tissue. As organ-specific blood flow remains equal, cardiac output will increase. The surplus of fatty tissue will act as an extra depot for lipid-soluble drugs like thiopental. As a consequence, peak-concentrations are expected to decrease, whereas the terminal half-life and steady state volume of distribution will increase.1 Physiological parameters such as cardiac output, flow and tissue distribution have a more direct relationship with pharmacokinetic parameters like distribution volumes and clearances. Inclusion of a parameter like cardiac output into a pharmacokinetic model may improve the accuracy of the model, especially with respect to fast acting drugs like intravenous anaesthetics.
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Reekers, M., Boer, F., Vuyk, J. (2003). Basic Concepts of Recirculatory Pharmacokinetic Modelling. In: Vuyk, J., Schraag, S. (eds) Advances in Modelling and Clinical Application of Intravenous Anaesthesia. Advances in Experimental Medicine and Biology, vol 523. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-9192-8_2
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DOI: https://doi.org/10.1007/978-1-4419-9192-8_2
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