Patient-Centred Monitoring of Vital Signs and Laboratory Parameters to Guide Pharmacotherapy: Insights from Anaesthesia

• Activity Number: 21
• Type: Topic Contributed
• Date/Time: Sunday, August 3, 2014 : 2:00 PM to 3:50 PM
• Sponsor: Biopharmaceutical Section
• Author(s): Chris Stockmann*+ and Michael G. Spigarelli and Catherine M.T. Sherwin and Alfred H. Balch
• Companies: and University of Utah and University of Utah School of Medicine and University of Utah
• Keywords: clinical pharmacology ; optimal design ; anaesthesia ; pharmacokinetics ; pharmacodynamics

Abstract

Predicting the time course and magnitude of drug effects is the primary task of clinical anaesthesiology. Inhaled anaesthetic agents feature low lipid solubility, which allows for the quick titration of drug doses to achieve rapid induction and emergence. Additionally, recent improvements in the opioids have greatly enhanced their potency, safety, and pharmacokinetic. In this study, we will demonstrate the application of pharmacokinetic and pharmacodynamic modelling and simulation in determining an optimal loading and maintenance dosing regimen for patients receiving the ultra-short-acting intravenous opioid remifentanil. Additionally, we will identify vital signs and laboratory parameters that exhibit a significant influence upon remifentanil clearance and volume of distribution. These data will then be used to develop a D-optimal sampling strategy for pre-clinical animal model studies of a novel remifentanil formulation, based upon previously ascertained pharmacokinetic parameters.