Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Aug 2010
ReviewPopulation pharmacokinetics and pharmacodynamics in anesthesia, intensive care and pain medicine.
Population modeling is a relatively new pharmacological discipline, the development of which has largely been stimulated by the need for accurate models for the pharmacokinetics and dynamics of anesthetic agents. ⋯ Nonlinear mixed-effect population-based modeling has become the gold standard method of pharmacokinetic and pharmacodynamic analysis during new drug development and during subsequent pharmacological studies. Population-based modeling techniques have been applied to numerous aspects of drug delivery in anesthesia, intensive care and pain medicine.
-
Interventions in the cardiac catheterization laboratory (CCL) requiring anaesthetic expertise are becoming routine. These interventions involve a heterogeneous patient population and take place in an offsite location. This review aims to give an insight into anaesthetic issues surrounding certain interventions and the challenges encountered in an offsite location. ⋯ Interventions in the CCL have developed to such an extent that dedicated anaesthesia teams are required in order to cope with the complexities of the patient populations, the interventions and the challenges brought by the offsite nature of the CCL.
-
Curr Opin Anaesthesiol · Aug 2010
Editorial ReviewAzole antimycotics and drug interactions in the perioperative period.
A beneficial effect of antifungal prophylaxis on the prevention of invasive fungal infections has increased the use of azole antimycotics in intensive care and during the perioperative period. At the same time more severe illnesses are treated and multiple drug therapies are employed. Thus, the potential for severe drug-drug interactions has increased. Previous studies have shown that azole antimycotics increase the risk of many clinically significant drug interactions with potentially hazardous consequences. ⋯ This review focuses on azole antimycotics and anesthetic drugs being used during the perioperative period and discusses the possible clinically significant drug-drug interactions. Azole antimycotics are amongst the strongest inhibitors of CYP-mediated drug metabolism. Anesthesiologists must be aware of the interaction potential of azole antimycotics to be able to adjust their perioperative strategies according to the patient's condition and concomitant medication.