Pharmacokinetic and Pharmacodynamic Modeling Applied to Anesthetic Drugs

  • Donald R. Stanski


Several different classes of drugs are used in clinical anesthetic practice. These include muscle paralyzing drugs, potent inhalational anesthetics, intravenous hypnotics and opioids. The measurement of drug effect for each of these classes differs in complexity and resolution. Many concepts of drug pharmacokinetic and pharmacodynamic modeling have been developed with anesthetic drugs. This has occurred because the drug effects are generally profound, can be quantitated in a reasonable manner and are relatively rapid in onset. Understanding anesthetic clinical pharmacology and therapeutics is intimately linked to pharmacokinetic and pharmacodynamic modeling concepts.


Nitrous Oxide Drug Effect Minimum Alveolar Concentration Anesthetic Drug Pharmacodynamic Modeling 
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  1. Ali, H. H., and J. J. Savarese (1976). Monitoring of neuromuscular function. Anesthesiology, 45,216–249.PubMedCrossRefGoogle Scholar
  2. Arden, J. R., F. O. Holley and D. R. Stanski (1986). Increased sensitivity to etomidate in the elderly: Initial distribution vs altered brain response. Anesthesiology, 65, 19–27.PubMedCrossRefGoogle Scholar
  3. Ausems, M. E., C. C. Hug, Jr., D. R. Stanski and A. G. L. Burm (1986). Plasma concentrations of alfentanil required to supplement nitrous oxide anesthesia for general surgery. Anesthesiology, 65, 362–373.PubMedCrossRefGoogle Scholar
  4. Ausems, M. E., J. Vuyk, C. C. Hug, Jr. and D. R. Stanski (1988). Comparison of computer-assisted vs intermittent bolus administration of alfentanil as a supplement to nitrous oxide for lower abdominal surgery. Anesthesiology, 68, 851–861.PubMedCrossRefGoogle Scholar
  5. Eger, E. I., L. J. Saidman and B. Brandstater (1965). Minimum alveolar anesthetic concentration: A standard of anesthetic potency. Anesthesiology, 26, 756–763.PubMedCrossRefGoogle Scholar
  6. Fisher, D. M., C. O’Keefe, D. R. Stanski, R. Cronnelly, R. D. Miller and G. H. Gregory (1982). Pharmacokinetics and pharmacodynamics of d-tubocurarine in infants, children, and adults. Anesthesiology, 57, 203–208.PubMedCrossRefGoogle Scholar
  7. Fisher, D. M., P. C. Canfell, M. J. Spellman and R. D. Miller (1990). Pharmacokinetics and pharmacodynamics of atracurium in infants and children. Anesthesiology, 73, 33–37.PubMedCrossRefGoogle Scholar
  8. Gibaldi, M., G. Levy, and W. Hayton (1972). Kinetics of the elimination and neuromuscular blocking effects of d-tubocurarine in man. Anesthesiology, 36, 213.PubMedCrossRefGoogle Scholar
  9. Gregory, T. K., and D. C. Pettus (1986). An electroencephalographic processing algorithm specifically intended for analysis of cerebral electrical activity. J. Clin. Mon.,2,190–197.CrossRefGoogle Scholar
  10. Hennis, P. J., and D. R. Stanski (1985). Pharmacokinetic and pharmacodynamic factors that govern the clinical use of muscle relaxants. Seminars in Anesthesia, 4, 21–30.Google Scholar
  11. Homer, T. D. and D. R. Stanski (1985). The effect of increasing age on thiopental disposition and anesthetic requirement. Anesthesiology, 62, 714–724.PubMedCrossRefGoogle Scholar
  12. Hull, C. J., H. B. Van Beem, K. McLeod, A. Sibbald and M. J. Watson (1978). A pharmacodynamic model for pancuronium. Br. J. Anaesth.,50, 1113–1123.PubMedCrossRefGoogle Scholar
  13. Hung, O. R., J. R. Varvel, S. L. Shafer and D. R. Stanski (1992). Thiopental pharmacodynamics. II Quantitation of clinical and EEG depth of anesthesia. Anesthesiology, 77, 237–244.PubMedCrossRefGoogle Scholar
  14. Lemmens, H. J. M., J. G. Bovill, P. J. Hennis, M. P. R. R. Gladines and A. G. L. Burm (1989). Alcohol consumption alters the pharmacodynamics of alfentanil. Anesthesiology, 71, 669–674.PubMedCrossRefGoogle Scholar
  15. Levy, W. J., H. M. Shapiro, G. Maruchak and E. Meathe (1980). Automated EEG processing for intraoperative monitoring: A comparison of techniques. Anesthesiology, 53, 223–236.PubMedCrossRefGoogle Scholar
  16. Martyn, J. A. J., K. Szynfelbein, H. H. Ali, R. S. Matteo and J. J. Savarese (1980). Increased d-tubocurarine requirement following major thermal injury. Anesthesiology, 52, 352–355.PubMedGoogle Scholar
  17. Quasha, A. L., E. I. Eger and J. H. Tinker (1980). Determination and applicaton of MAC. Anesthesiology, 53, 315–334.PubMedCrossRefGoogle Scholar
  18. Scott, J. C., J. E. Cooke and D. R. Stanski (1991). EEG quantitation of opiate effect:Comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology, 74, 34–42.PubMedCrossRefGoogle Scholar
  19. Scott, J. C., K. V. Ponganis and D. R. Stanski (1985). EEG quantitation of narcotic effect:The comparative pharmacodynamies of fentanyl and alfentanil. Anesthesiology, 62, 234–241.PubMedCrossRefGoogle Scholar
  20. Shafer, S. L., J. R. Varvel, N. Aziz and J. C. Scott (1990). Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. Anesthesiology, 73, 1091–1102.PubMedCrossRefGoogle Scholar
  21. Sheiner, L. B., D. R. Stanski, S. Vozeh, J. Ham and R. D. Miller (1979). Simultaneous modeling of pharmacokinetics and pharmacodynamics: Application to d-tubocurarine. Clin. Pharmacol. Ther.25, 358–371.PubMedGoogle Scholar
  22. Stanski, D. R. (1990) In R. D. Miller (Ed.), Anesthesia 3rd edition, Churchill-Livingston, New York. Chap 30.Google Scholar
  23. Stanski, D. R. and P. 0. Maitre (1990). Population pharmacokinetics and pharmacodynamics of thiopental:The effect of age revisited. Anesthesiology, 72, 412–422.PubMedCrossRefGoogle Scholar
  24. Stanski, D. R., J. Ham, R. D. Miller and L. B. Sheiner (1979). Pharmacokinetics and pharmacodynamics of d-tubocurarine during nitrous oxide-narcotic and halothane anesthesia in man. Anesthesiology, 51, 235–241.PubMedCrossRefGoogle Scholar
  25. Stoelting, R. K., D. E. Longnecker and E. I. Eger (1970). Minimum alveolar concentrations in man on awakening from methoxyflurane, halothane, ether and fluroxene anesthesia: MAC awake. Anesthesiology, 33, 5–9.PubMedCrossRefGoogle Scholar
  26. Yakaitis, R. W., C. D. Blitt and J. P. Angiulo (1970). End-tidal halothane concentration for endotracheal intubation. Anesthesiology, 47, 386–388.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Donald R. Stanski
    • 1
    • 2
  1. 1.Departments of Anesthesia and Medicine (Clinical Pharmacology)Stanford University School of MedicineStanfordUSA
  2. 2.Palo Alto Veterans Administration HospitalPalo AltoUSA

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