Pharmacokinetic and Pharmacodynamic Interactions Relevant to Cerebral Monitoring
Many drugs acting on the central nervous system produce characteristic changes on the electroencephalogram (EEG). As early as the third decade of this century, Berger described in several papers that morphine, cocaine, barbiturates, and scopolamine altered the EEG [1,2]. In the last 10 years, drug-induced EEG changes have been described in detail for many intravenous drugs used in anesthesia. It has now generally been established that drugs acting on the central nervous system cause EEG changes that are specific, continuous, measurable, objective, sensitive, and reproducible. These properties made the EEG a powerful tool to measure drug effects. However, the correlation between EEG drug effects and clinical drug effects such as analgesia, hypnosis, and sedation has not yet been unraveled and remains to be definitively established. Therefore, the EEG must be considered as a “surrogate” effect measurement. A surrogate measure of effect can be defined as a secondary, drug-induced, measurable change in body physiology.
KeywordsMorphine Cocaine Diazepam Fentanyl Midazolam
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