Gerry's Real World Guide to Pharmacokinetics & Other Things

24 October 2010
14:58

1. BOB

Normal plasma epinephrine concentration: 0.01-0.1 mcg/L

Epinephrine t1/2 : 11 min

Human capillary endothelium barrier MW> 10,000 gs/mol

Epinephrine MW: 183.2 gs/mol

Cl=Qx(1-(Cvenous/Carterial))
Cl: Clearance L/min
Q: flow of plasma through an organ or the whole body L/min
E=ClxCarterial
E: Drug Elimination rate mg/min

2. ASLEEP IN TEN SECONDS!!

Rolling Veins

ASE technique: All Syringes Empty

arteria temporalis superficialis pulse in front of the tragus: Ø SBP< 70-80mmHg

arteria radialis pulse: Ø SBP< 40-50mmHg

Tragus is about the same level as the brainstem.

Brain stem ssConcentration Minimal plasma Concentration

Causing hypnosis (mg/dl) Causing myocardial depression (mg/dl)

Thiopental 10 70

Methohexital 3.4 10

Etomidate 0.21 15

Propofol 2 10

Some circulation times

From where to where Time (sec)

Arm vein to lung 5-8

Arm vein to left ventricle 6-8

Arm vein to tongue 12-15

Arm vein to brain 13-20

Foot vein to tongue 37-47

Right heart to ear 8

Arm to foot 21-35

3. COMPARTMENTALIZED & DISTRIBUTED

Suction pot

Organ weight and blood flow

Organ Organ blood flow Organ weight

(mL/100g/min) (% body weight)

Kidneys 340 0.5

Liver 100 2

Heart 69 0.4

Brain 54 2.3

Skeletal muscle 10-12 43

Skin 11 7

Adipose tissue 2-7 16-36

C=Be-βt One compartment model

C: plasma drug concentration
B: drug specific constant
e: 2.718
t: elapsed time after drug administration
β: drug specific constant = 0.693/t1/2β, t1/2β=plasma elimination half life of the drug

C=Ae-αt + Be-βt Two compartment model

t1/2α: distribution half-life
t1/2β: elimination half-life

Fat-soluble drugs: rapid onset; Vc, Vd >> plasmaV; eg.: thiopental, propofol
Fat-insoluble, highly ionised drugs: slower onset; Vc, Vd ≥ plasmaV; eg: muscle relaxants
Highly protein bound drugs: Vd, Vc > plasmaV; eg: opiates

4. PARALYSED FOR HOURS

5. BLOOD LOSS, DRUG LOSS