Pharmacokinetic Characteristics
The use of inhalational
anesthetics is generally reserved for maintenance of anesthesia. The
development of an anesthetic concentration in the brain occurs more slowly with
inhalational anesthetics than with IV drugs. Once an anesthetic level has been
achieved, however, it is easily adjusted by controlling the rate or
concentra-tion of gas delivery from the anesthesia machine. The rate of
recovery from a lengthy procedure in which in-halational agents are used is
reasonably rapid, since in-halational anesthetics are eliminated by the lungs
and do not depend on a slow rate of metabolism for their tissue clearance. Thus,
inhalational drugs meet the re-quirement for a relatively prompt return of the
patient’s psychomotor competence.
Pharmacokinetic factors that
influence the distribu-tion of gases control the establishment of anesthetic
concentrations in tissue. Thus, factors influencing gas distribution in tissues
are important to the anesthesiol-ogist, who must control anesthetic delivery
and adjust for physiological influences and/or pathological condi-tions that
can alter the accumulation of the gas. Unlike most drugs whose equilibration
with tissues involves concentration gradients, partial pressure gradients
con-trol the equilibration of gases between various tissue compartments.
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