Abstract
In every day clinical practice anaesthesiologists administer drugs based on rough estimations of the patient’s needs. These rough estimations are based on a basic understanding of the pharmacokinetics and pharmacodynamics of the drugs used and the patient’s variables that influence these. A proper assessment of the pharmacokinetics and dynamics of a drug in an individual patient is important because side effects of anaesthetic agents are serious. Inappropriately low drug concentrations during general anaesthesia will lead to nociception and/or an insufficient level of unconsciousness whereas inappropriately high drug concentrations lead to undesired cardiovascular and/or ventilatory depression. Next to the pharmacokinetics and dynamics of single agents, anaesthetic agents also affect each other’s distribution and elimination and effect at the receptor site. Pharmacokinetic interactions cause blood drug concentrations to change by 10-15% and are therefore of less importance compared to the pharmacodynamic interactions that may shift concentration-effect curves of the second agent by up to 400%.1,2 The modelling of pharmacodynamic interactions has been an area developing very rapidly over the past 10-20 years and its current status is discussed in this chapter.
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Minto, C., Vuyk, J. (2003). Response Surface Modelling of Drug Interactions. 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_4
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DOI: https://doi.org/10.1007/978-1-4419-9192-8_4
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