麻醉药的药代/药效学模型及其临床应用  

Pharmacokinetic-Pharmacodynamic Models of Anesthetic Drugs and Clinical Applications Thereof

作　　者：许文妍[1] 董希玮[2] 张马忠[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心麻醉科儿童临床药理研究室,上海200127 [2]新疆生产建设兵团医院麻醉科,新疆乌鲁木齐830002

出　　处：《药学进展》2017年第5期355-360,共6页Progress in Pharmaceutical Sciences

基　　金：国家自然科学基金(No.81270414);上海市卫计委重要薄弱学科项目(No.2015ZB0106);兵团临床重点建设专科项目(No.ZK1500MZ01)

摘　　要：麻醉是药物诱导的一种或多种行为状态,包括意识消失、遗忘、镇痛及麻痹等,常需联合使用多种麻醉药物。与其他临床治疗药物不同,麻醉药给药后迅速分布于血液、脑或其他作用部位,数分钟内产生麻醉效应并可在数分钟或数小时内恢复。麻醉药的药理效应平行于效应位浓度,但无论是单次注射还是持续给药,效应位浓度及药物效应总是滞后于血浆药物浓度。为精确控制麻醉药物效应,需充分了解其浓度随时间的变化过程和特点。重点介绍静脉麻醉药的药代/药效学、建模、浓度-效应关系和药物相互作用研究情况,为麻醉医师优化药物临床使用方案及对其开展进一步相关研究提供参考。Anesthesia is a temporarily induced state with one or more of unconsciousness, amnesia, analgesia and paralysis. It is achieved by combined use of several classes of drugs. Being different from other therapeutic drugs, anesthetics are quickly distributed into blood, brain or other action sites after administration, and produce anesthetic effect within a few minutes, which can be reversed in a few minutes or hours. The pharmacological effects of anesthetics and drug concentration at site of action are in parallel, however, both are hysteric compared with plasma concentration regardless of bolus or continuous intravenous injection. Therefore, accurate control of anesthetic effects needs full understanding of concentration-time course. In this review, the basis of pharmacokinetics/pharmacodynamics, modeling, concentration-effect relationship, and drug interactions of intravenous anesthetics were discussed, so as to provide anesthesiologists with reference for optimizing clinical regimen of anesthetics and conducting further investigations.

关 键 词：药代学药效学 麻醉药 建模 药物相互作用 靶控输注 

分 类 号：R614[医药卫生—麻醉学]