Advertisement

Pharmacokinetic and Pharmacodynamic Interactions Relevant to Cerebral Monitoring

  • H. J. M. Lemmens

Abstract

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.

Keywords

Pharmacodynamic Modeling Pharmacodynamic Interaction Spectral Edge Spectral Edge Frequency Effect Site Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Berger H (1931) Über das Elektroenkephalogramm des Menschen.III. Mitteilung. Arch Psychiatr Nervenkr 94:16–60CrossRefGoogle Scholar
  2. 2.
    Berger H (1933) Über das Elektroenkephalogramm des Menschen. VIII. Mitteilung. Arch Psychiatr Nervenkr 101:453–469Google Scholar
  3. 3.
    Stanski DR, Hudson RJ, Homer TD, Saidman LJ, Math, E (1984) Pharmacodynamic modeling of thiopental anesthesia. J Pharmacokinet Biopharm 12:223–240PubMedCrossRefGoogle Scholar
  4. 4.
    Schuttler J, Stanski DR, White PF, Trevor AJ, Horai Y, Verotta D, Sheiner LB (1987) Pharmacodynamic modeling of the EEG effects of ketamine and its enantio- mers in man. J Pharmacokinet Biopharm 15:241–253PubMedCrossRefGoogle Scholar
  5. 5.
    Verotta D, Sheiner LB (1987) Simultaneous modeling of pharmacokinetics and pharmacodynamics:an improved algorithm. CABIOS 3:345–349PubMedGoogle Scholar
  6. 6.
    Scott JC, Ponganis KV, Stanski DR (1985) EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology 62:234–241PubMedCrossRefGoogle Scholar
  7. 7.
    Schwilden HJ, Schuttler J, Stoeckel H (1985) Quantitation of EEG and pharmacodynamic modeling of hypnotic drugs etomidate as an example. Eur J Anaesthesin 2:121Google Scholar
  8. 8.
    Scott JC, Cooke JE, Stanski DR (1991) Electroencephalographic quantitation of opioid effect:comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology 74:34–42PubMedCrossRefGoogle Scholar
  9. 9.
    Mandema JW (1991) EEG effect measures and relationships between pharmacokinetics and pharmacodynamics of psychotropic drugs. Thesis, State University Leiden, The NetherlandsGoogle Scholar
  10. 10.
    Buhrer M, Maitre P, Crevoisier C, Stanski DR (1990) Electroencephalographic effects of benzodiazepines.il. Pharmacodynamic modeling of the electroencephalographic effects of midazolam and diazepam. Clin Pharmacol Ther 48:544–554PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • H. J. M. Lemmens

There are no affiliations available

Personalised recommendations