Targeting the Effect Site with a Computer Controlled Infusion Pump
Over the last decade computer controlled infusions have been used to rapidly achieve and maintain constant plasma drug concentrations for drugs having pharmacokinetics characterized by polyexponential disposition functions. For most drugs the plasma is not the site of drug effect. Thus, targeting the plasma drug concentration may not be a rational approach to optimal drug therapy. Drawing on previously described effect site models, an algorithm is developed for computer controlled infusion pumps to target the apparent concentration at the site of drug effect, rather than the concentration in the plasma. Simulations are based on the pharmacokinetics and plasma-effect site equilibration delay that have been reported for fentanyl, an intravenous opioid commonly used in anesthetic practice.
KeywordsDrug Effect Bolus Injection Effect Site Plasma Drug Concentration Target Concentration
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