PHARMACOKINETICS OF FENTANYL ADMINISTERED BY COMPUTER-CONTROLLED INFUSION PUMP
PHARMACOKINETICS OF FENTANYL ADMINISTERED BY COMPUTER-CONTROLLED INFUSION PUMP
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DOI：
10.1097/00000542-199012000-00005
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发表时间：
1990-12-01
期刊：
影响因子：
8.8
通讯作者：
SCOTT, JC
中科院分区：
文献类型：
--
作者：
SHAFER, SL;VARVEL, JR;SCOTT, JC
根据药代动力学模型，使用计算机控制的输液泵（CCIP）对21例患者给予芬太尼。11例患者根据McClain和Hug描述的药代动力学给药，10例患者根据Scott和Stanski描述的药代动力学给药。作者测量了每个药代动力学参数集的实测动脉芬太尼浓度与CCIP预测浓度之间的差异。根据Scott和Stanski参数给药的患者中位绝对性能误差（MDAPE）为33%。根据McClain和Hug's参数的人群为61%，使用汇总数据技术分析了这21例患者的MDAPE给药代动力学。芬太尼在该人群中的药代动力学显示，与之前估计的芬太尼相比，中央室体积较小，初始分布半衰期更快。衍生的药代动力学参数很好地描述了这些患者，并预测了从四个先前发表的芬太尼研究中观察到的芬太尼浓度，具有合理的准确性。作者使用的参数与McClain和Hug使用的参数的比较表明，根据药代动力学模型设计的给药方案在原始研究中采样的时间点可能相当准确，但在原始研究中未采样的时间点可能不准确。作者得出结论，尽管CCIP法测定的芬太尼阿敏的药代动力学与推注或恒速输注法测定的芬太尼药代动力学相同，但使用CCIP法进行的药代动力学研究在表征最快速分布的药代动力学参数方面可能特别有效，因此可能提供适合随后在CCIP中使用的参数。
Fentanyl was administered to 21 patients using a computer-controlled infusion pump (CCIP) based on a pharmacokinetic model. Eleven of the patients were dosed according to the pharmacokinetics described by McClain and Hug, and ten of the patients were dosed according to the pharmacokinetics described by Scott and Stanski. The authors measured the difference between the measured arterial fentanyl concentrations and the concentrations predicted by the CCIP for each pharmacokinetic parameter set. The median absolute performance error (MDAPE) in patients dosed according to Scott and Stanski''s parameters was 33%. The population according to McClain and Hug''s parameters was 61%, and the MDAPE in patients dosed pharmacokinetics in these 21 patients were analyzed using a pooled data technique. The pharmacokinetics of fentanyl in this population showed a smaller centralcompartment volume and a more rapid initial distribution half-life than previously estimated for fentanyl. The derived pharmacokinetic parameters described these patients well and also predicted the observed fentanyl concentrations from four previously published fentanyl studies with reasonable accuracy. Comparison of the parameters used by the authors with those of McClain and Hug demonstrated that dosing regimens designed from pharmacokinetic models can be fairly accurate at the times sampled in the original study but may not be accurate at time points not sampled in the original research. The authors concluded that although the pharmacokinetics of fentanyl acministered by CCIP are the same as the pharmacokinetics of fentanyl administered by a bolus or constant rate infusion, a pharmacokinetic study using a CCIP may be particularly effective at characterizing the most rapid distribution pharmacokinetic parameters, and thus may provide parameters appropriate for subsequent use in a CCIP.