Abstract
Background: The purpose of this study was to investigate the in vivo pharmacodynamics and the pharmacodynamic interactions of remifentanil and its major metabolite, GR90291, in a rat electroencephalographic model. Methods: Remifentanil and GR90291 were administered according to a stepwise infusion scheme. The time course of the electroencephalographic effect (0.5-4.5 Hz) was determined in conjunction with concentrations of the parent drug and the metabolite in blood. Results: Administration of remifentanil resulted in concentrations of remifentanil and GR90291 in the ranges 0-120 ng/ml and 0- 850 ng/ml, respectively. When the metabolite was administered, concentrations of the metabolite in the range 0-220 μg/ml and no measurable concentrations of remifentanil were observed. The mean ± SE values of the pharmacokinetic parameters clearance and volume of distribution at steady state were 920 ± 110 ml·min-1·kg-1 and 1.00 ± 0.93 l/kg for remifentanil and 15 ± 2 ml·min-1·kg-1 and 0.56 ± 0.08 l/kg for GR90291. The relative free concentrations in the brain, as determined on the basis of the cerebrospinal fluid/total blood concentration ratio at steady state, were 25 ± 5% and 0.30 ± 0.11% for remifentanil and GR90291, respectively. Concentration- electroencephalographic effect relations were characterized on the basis of the sigmoidal E(max) pharmacodynamic model. The mean ± SE values for the maximal effect (E(max)), the concentration at which 50% of the maximal effect is obtained (EC50), and Hill factor for remifentanil were 109 ± 12 μV, 9.4 ± 0.9 ng/ml, and 2.2 ± 0.3, respectively (n = 8). For GR90291, the mean ± SE values for EC50 and the Hill factor were 103,000 ± 9,000 μg/ml and 2.5 ± 0.4, respectively (n = 6). Conclusions: Analysis of the data on the basis of a previously postulated, mechanism-based pharmacokinetic- pharmacodynamic model for synthetic opioids revealed that the low in vivo potency of GR90291 can be explained by a low affinity to the μ-opioid receptor in combination with a poor brain penetration.
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Cox, E. H., Langemeijer, M. W. E., Gubbens-Stibbe, J. M., Muir, K. T., & Danhof, M. (1999, February). The comparative pharmacodynamics of remifentanil and its metabolite, GR90291, in a rat electroencephalographic model. Anesthesiology. https://doi.org/10.1097/00000542-199902000-00030
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