Vecuronium Pharmacokinetic-Pharmacodynamic Modelling With and Without a Receptor Concentration in the Effect Compartment in Anaesthetised Patients
作者:
Julie Ducharme,
France Varin,
François Donati,
期刊:
Drug Investigation
(ADIS Available online 1994)
卷期:
Volume 7,
issue 2
页码: 74-83
ISSN:0114-2402
年代: 1994
出版商: ADIS
数据来源: ADIS
摘要:
The pharmacokinetic-pharmacodynamic (PK-PD) relationship of vecuronium administered as a 0.1 mg/kg intravenous bolus was evaluated during both the onset of and recovery from neuromuscular block in 9 anaesthetised patients. Sigmoid Emaxmodelling of neuromuscular block versus vecuronium effect compartment concentrations indicated comparable effective concentrations at 50% block (EC50) for both onset and recovery (146 ± 12vs144 ± 13 ng/ml, respectively). However, during onset, the sigmoid was systematically steeper (gamma of 6.41 ± 0.32vs4.17 ± 0.36, respectively). Including a finite receptor concentration in the effect compartment (0.27 ± 0.04 μmol/L) led to a faster equilibration rate constant, Keo(0.097 ± 0.009vs0.058 ± 0.005 min-1) and to lower EC50(120 ± 13 ng/ml) and gamma values (3.62 ± 0.22). The neuromuscular block predicted by this model was similar to the one obtained from a separate PK-PD analysis over each phase. Therefore, to be adequate, the PK-PD modelling of non-depolarising neuromuscular blockers should involve a separate analysis of onset or recovery data, or account for the safety margin of neuromuscular transmission by adding a receptor concentration in the effect compartment.
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