Book contents
- Personalized Anaesthesia
- Personalized Anaesthesia
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section 1 Basic Principles
- 1 Principles of Quantitative Clinical Pharmacology
- 2 Pharmacokinetic and Pharmacodynamic Modelling in Anaesthesia
- 3 Drug Interactions: Additivity and Synergy among Anaesthetic Drugs
- 4 Covariate Analysis in Clinical Anaesthesia
- 5 Signal Analysis and Response Measurement
- 6 Application of Pharmacokinetics and Pharmacodynamics and Signal Analysis to Drug Administration in Anaesthesia
- Section 2 Targeting Effects
- Index
- References
4 - Covariate Analysis in Clinical Anaesthesia
from Section 1 - Basic Principles
Published online by Cambridge University Press: 03 December 2019
- Personalized Anaesthesia
- Personalized Anaesthesia
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section 1 Basic Principles
- 1 Principles of Quantitative Clinical Pharmacology
- 2 Pharmacokinetic and Pharmacodynamic Modelling in Anaesthesia
- 3 Drug Interactions: Additivity and Synergy among Anaesthetic Drugs
- 4 Covariate Analysis in Clinical Anaesthesia
- 5 Signal Analysis and Response Measurement
- 6 Application of Pharmacokinetics and Pharmacodynamics and Signal Analysis to Drug Administration in Anaesthesia
- Section 2 Targeting Effects
- Index
- References
Summary
The goal of pharmacological treatment is a desired response, known as the target effect (e.g. bispectral index of 50). An understanding of the concentration–response relationship (i.e. pharmacodynamics (PD)) can be used to predict the target concentration (e.g. propofol 4 mg/L) required to achieve this target effect in a typical individual [1]. Pharmacokinetic (PK) knowledge (e.g. clearance, volume) then determines the dose that will achieve the target concentration. Each individual, however, is somewhat different and there is variability associated with all parameters used in PK and PD equations (known as models). Covariate information (e.g. weight, age, pathology, drug interactions, pharmacogenomics) can be used to help predict the dose in a specific patient. The Holy Grail of clinical pharmacology is prediction of drug PK and PD in the individual patient (Fig. 4.1) and this requires knowledge of the covariates that contribute to variability [2].
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- Personalized AnaesthesiaTargeting Physiological Systems for Optimal Effect, pp. 40 - 62Publisher: Cambridge University PressPrint publication year: 2020