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Use of a limited physiologic model to explain target organ toxicity of bupivacaine as a function of route of administration
Author(s) -
Denson Donald D.,
Thompson Gary A.,
Coyle Dennis E.
Publication year - 1986
Publication title -
biopharmaceutics and drug disposition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.419
H-Index - 58
eISSN - 1099-081X
pISSN - 0142-2782
DOI - 10.1002/bdd.2510070204
Subject(s) - bupivacaine , toxicity , cardiac toxicity , epidural administration , anesthesia , medicine , pharmacology , central nervous system , local anesthetic , pharmacokinetics
A physiologic model to describe bupivacaine uptake by and elimination from brain and heart was developed. Preliminary validation of the model was accomplished by comparing concentration data predicted by the model with those determined in rabbits. The model was modified to examine similarities and differences following intravenous and epidural administration of 150 mg of bupivacaine in humans. Simulations illustrated why rapid cardiovascular and central nervous system toxicity occurs following intravenous administration and is absent when an identical dose is administered epidurally. A slow continuous intravenous infusion of bupivacaine was simulated to examine the possibility that brain and heart concentrations would continue to accumulate reaching toxic concentrations in the absence of blood concentrations associated with bupivacaine toxicity.