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Pharmacokinetic and Pharmacodynamic Modeling in Anesthesia

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The Wondrous Story of Anesthesia

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Abstract

Before 1950, we little understood what drugs did to patients (pharmacodynamics) or what patients did to drugs (pharmacokinetics). In 1949, Faulconer et al correlated the EEG with the sedative/anesthetic effects of nitrous oxide. In 1960, Price simulated thiopental pharmacokinetics. In 1963, Eger extended the simulation to inhaled anesthetics and invented MAC. From 1972 to 1997, Sheiner and Rosenberg used computer models to predict pharmacokinetics in individuals, leading to the population principle. In 1978, Hull used the effect site concept to understand the time course of pancuronium’s effect. From 1978 to 1986, Sheiner and Beal defined methods for estimating the parameters controlling drug behavior, developing NONMEM to estimate population pharmacokinetics. In the 1980s, Schwilden published models allowing control of anesthetic concentrations. With Stoeckel, he devised a target controlled infusion (TCI) system that could maintain a target drug concentration.

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Authors and Affiliations

  1. P Less Than, 218 Castenada Avenue, 94116, San Francisco, CA, USA

    Dennis M. Fisher MD

  2. School of Medicine, Stanford University, 300 Pasteur Drive, MC-5640, 94305-5640, Stanford, CA, USA

    Steven L. Shafer MD

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Correspondence to Dennis M. Fisher MD .

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Editors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA

    Edmond I Eger II MD Emeritus Professor

  2. Departments of Anesthesia, Stanford University, Stanford, CA, USA

    Lawrence J. Saidman MD Emeritus Professor

  3. Geoffrey Kaye Museum of Anaesthetic History, Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia

    Rod N. Westhorpe OAM, MB, BS FRCA, FANZCA Former Honorary Curator

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Fisher, D., Shafer, S. (2014). Pharmacokinetic and Pharmacodynamic Modeling in Anesthesia. In: Eger II, E., Saidman, L., Westhorpe, R. (eds) The Wondrous Story of Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8441-7_40

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