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静脉麻醉药药理学的临床应用:以催眠药和阿片类药物为例

[Clinical applications of intravenous anaesthetics pharmacology: the example of hypnotics and opioids].

作者信息

Lagneau F, Tod M, Marty J

机构信息

Service d'anesthésie-réanimation, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92118 Clichy, France.

出版信息

Ann Fr Anesth Reanim. 2004 Oct;23(10):986-97. doi: 10.1016/j.annfar.2004.07.015.

Abstract

OBJECTIVE

To review the general principles of pharmacokinetics and pharmacodynamics models by focusing on intravenous anaesthetics (hypnotics and opioids).

DATA SOURCES

Medline references, lectures from the French congress of anaesthesiology and intensive care medicine, abstracts.

DATA SYNTHESIS

Pharmacokinetic and pharmacodynamic modelling allows simple estimation of becoming of anaesthetic drugs in the body, instead of classical pharmacologic approach. However, pharmacokinetic as well as pharmacodynamic parameters are often considered as resulting from complex mathematic approaches and remain then poorly used in practice by physicians. The aim of this article is to simply expose concepts underlying PK-PD models building and to explain significance of the main PK-PD parameters (first-order rate constants, k(e0), T(1/2)k(e0), T(peak), context-sensitive half-time, context-sensitive decrement times). Clinical consequences for using intravenous anaesthetic drugs (hypnotics and opioids) are exposed either during bolus injection or continuous infusion, when injected alone or co-administered.

摘要

目的

通过聚焦静脉麻醉药(催眠药和阿片类药物)来回顾药代动力学和药效学模型的一般原理。

数据来源

医学文献数据库参考文献、法国麻醉学与重症医学大会讲座、摘要。

数据综合

药代动力学和药效学建模允许对麻醉药物在体内的变化进行简单估计,而不是采用传统的药理学方法。然而,药代动力学以及药效学参数通常被认为是复杂数学方法的结果,因此在实践中医生很少使用。本文的目的是简单阐述药代动力学-药效学模型构建的基本概念,并解释主要药代动力学-药效学参数(一级速率常数、k(e0)、T(1/2)k(e0)、T(peak)、时效半衰期、时效递减时间)的意义。文中阐述了静脉麻醉药(催眠药和阿片类药物)在单次注射或持续输注时单独使用或联合使用的临床后果。

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