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Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump

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Abstract

Computer-controlled infusion pumps incorporating an internal model of drug pharmacokinetics can rapidly achieve and maintain constant drug concentrations in the plasma. Although these pumps offer more accurate titration of intravenous drugs than is possible with simple boluses or constant rate infusions, the choice of the plasma as the target site is arbitrary. The plasma is not the site of drug effect for most drugs. This manuscript describes two algorithms for calculation of the infusion rates necessary for a computer-controlled infusion pump to rapidly achieve, and then maintain, the desired target concentration at the site of drug effect rather than in the plasma.

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References

  1. H. Schwilden. A general method for calculating the dosage scheme in linear pharmacokinetics.Eur. J. Clin. Pharmacol.20:379–383 (1981).

    Article CAS PubMed  Google Scholar 

  2. J. Bailey and S. L. Shafer. A simple analytical solution to the three compartment pharmacokinetic model suitable for computer controlled infusion pumps.IEEE Trans. Biomed. Eng.38:522–525 (1991).

    Article CAS PubMed  Google Scholar 

  3. P. Martin and A. A. Ahuja. Optimal pharmacokinetic delivery of infused drugs: application to the treatment of cardiac arrhythmias.J. Biomed. Eng.10:360–384 (1988).

    Article CAS PubMed  Google Scholar 

  4. H. F. Hill, L. Saeger, R. Bjurstrom, G. Donaldson, C. R. Chapman, and R. Jacobson. Steady-state infusions of opioids in human volunteers. I. Pharmacokinetic tailoring.Pain43:57–67 (1990).

    Article CAS PubMed  Google Scholar 

  5. J. M. Alvis, J. G. Reves, A. V. Govier, P. G. Menkhaus, C. E. Henling, J. A. Spain, and E. Bradley. Computer assisted continuous infusions of fentanyl during cardiac anesthesia: comparison with a manual method.Anesthesiology63:41–49 (1985).

    Article CAS PubMed  Google Scholar 

  6. J. M. Alvis, J. G. Reves, J. A. Spain, and L. C. Sheppard. Computer-assisted continuous infusion of the intravenous analgesic fentanyl during general anesthesia—an interactive system.IEEE Trans. Biomed. Eng.32:323–329 (1985).

    Article CAS PubMed  Google Scholar 

  7. S. L. Shafer, J. R. Varvel, N. Aziz, and J. C. Scott. Pharmacokinetics of fentanyl administered by computer controlled infusion pump.Anesthesiology73:1091–1102 (1990).

    Article CAS PubMed  Google Scholar 

  8. P. S. Glass, J. R. Jacobs, L. R. Smith, B. Ginsberg, T. J. Quill, S. A. Bai, and J. G. Reves. Pharmacokinetic model-driven infusion of fentanyl: Assessment of accuracy.Anesthesiology73:1082–1090 (1990).

    Article CAS PubMed  Google Scholar 

  9. M. E. Ausems, D. R. Stanski, and C. C. Hug. An evaluation of the accuracy of pharmacokinetic data for the computer assisted infusion of alfentanil.Br. J. Anaesth.57:1217–1225 (1985).

    Article CAS PubMed  Google Scholar 

  10. D. B. Raemer, A. Buschman, J. R. Varvel, B. K. Philip, M. D. Johnson, D. A. Stein, and S. L. Shafer. The prospective use of population pharmacokinetics in a computerdriven infusion system for alfentanil.Anesthesiology73:66–72 (1990).

    Article CAS PubMed  Google Scholar 

  11. M. Bührer, P. O. Maitre, W. F. Ebling, and D. R. Stanski. Defining thiopental's steadystate plasma concentration-EEG effect relationship.Anesthesiology67:A399 (1987).

    Article  Google Scholar 

  12. R. M. Tackley, G. T. Lewis, C. Prys-Roberts, R. W. Boaden, J. Dixon, and J. T. Harvey. Computer controlled infusion of propofol.Br. J. Anaesth.62:46–63 (1989).

    Article CAS PubMed  Google Scholar 

  13. L. L. Gustafsson, W. F. Ebling, F. Osaki, D. R. Stanski, and S. L. Shafer. Plasma concentration clamping in the rat using a computer-controlled infusion pump.Pharm. Res.9(6) (1992).

  14. C. J. Hull, H. B. Van Beem, K. McLeod, A. Sibbald, and M. J. Watson. A pharmacodynamic model for pancuronium.Br. J. Anaesth.50:1113–1123 (1978).

    Article CAS PubMed  Google Scholar 

  15. L. B. Sheiner, D. R. Stanski, S. Vozeh, R. D. Miller, and J. Ham. Simultaneous modeling of pharmacokinetics and pharmacodynamics: Application to d-tubocurarine.Clin. Pharmacol. Ther.25:358–371 (1979).

    CAS PubMed  Google Scholar 

  16. J. C. Scott and D. R. Stanski: Decreased fentanyl/alfentanil dose requirement with increasing age: A pharmacodynamic basis.J. Pharmacol. Exp. Ther.240:159–166 (1987).

    CAS PubMed  Google Scholar 

  17. P. O. Maitre, M. E. Ausems, S. Vozeh, and D. R. Stanski. Evaluating the accuracy of using population pharmacokinetic data to predict plasma concentration of alfentanil.Anesthesiology68:59–67 (1988).

    Article CAS PubMed  Google Scholar 

  18. J. R. Jacobs. Analytical solution to the three-compartment pharmacokinetic model.IEEE Trans. Biomed. Eng.35:763–765 (1988).

    Article CAS PubMed  Google Scholar 

  19. W. E. Boyce and R. C. DiPrima.Elementary Differential Equations and Boundary Value Problems, Wiley & Sons, New York, 1977.

    Google Scholar 

  20. C. E. Pearson (Ed.).Handbook of Applied Mathematics, Van Nostrand Reinhold, New York, 1974.

    Google Scholar 

  21. W. H. Press, B. P. Flannery, S. A. Teukolsky, and W. T. Vetterling.Numerical Recipes in C, Cambridge University Press, New York, 1988.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Anesthesiology Service (112A), Palo Alto Veterans Administration Medical Center, 3801 Miranda Avenue, 94304, Palo Alto, California

    Steven L. Shafer

  2. Department of Statistics, Stanford University, Stanford, California

    Keith M. Gregg

Authors
  1. Steven L. Shafer
  2. Keith M. Gregg

Additional information

This study was supported in part by the Veterans Administration Merit Review Program, a Starter Grant from the American Society of Anesthesiologists, and Biomedical Research Support Grant RR05353 awarded by the Biomedical Research Support Grant Program, Division of Research Resources, National Institutes of Health, and the Anesthesia/Pharmacology Research Foundation.

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Shafer, S.L., Gregg, K.M. Algorithms to rapidly achieve and maintain stable drug concentrations at the site of drug effect with a computer-controlled infusion pump.Journal of Pharmacokinetics and Biopharmaceutics20, 147–169 (1992). https://doi.org/10.1007/BF01070999

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