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Additional resources for Anesthesia [2 vols]

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An understanding of pharmacokinetic and pharmacodynamic principles provides the anesthesiologist with a scientific foundation for using drugs to achieve specific therapeutic objectives. These principles form the basis for the application of pharmacologic science to the practice of anesthesia. , Copyright © 2000 Churchill Livingstone, Inc. PHARMACOKINETICS Overview Pharmacokinetics is the relationship between drug dose and plasma or effect-site drug concentration. The processes of absorption, distribution, and clearance govern this relationship.

We can also interpret Figure 2-6 (Figure Not Available) in terms of the metabolic rate (Y axis). As long as the metabolic rate is less than one-third of the maximum metabolic capacity, the rate of metabolism increases proportionally with concentration. The clinical message is that the metabolism is proportional to concentration, and thus pharmacokinetics remains linear, provided the rate of intravenous administration at steady state does not exceed one-third the maximum metabolic capacity. So far, we have discussed the rate of metabolism and not hepatic clearance.

Cognizant of the presence of the many small veins, venae spinosum, about the spinal column and cord, Corning reasoned that it might be possible to utilize cocaine therapeutically. Accordingly, in a young dog, about 20 minims of a 2 percent solution of cocaine was injected between the spinous processes of the dorsal vertebrae. After some minutes, incoordination of the posterior extremities developed, followed by insensibility. These results were almost immediately applied to a patient, a man suffering from spinal weakness and seminal incontinence.

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