Pediatric TCI: A new pharmacokinetic-pharmacodynamic theory proposal-part one

Abstract

New theoretical research of pharmacokinetic-pharmacodynamics constants for anaesthetic drugs are discussed in this report. Our study aims to set up a new algorithm to be validate and eventually insert in a new theoretical software. The algorithm will be installed in a new Target Controlled Infusion (TCI) System dedicated to neonatal and paediatric anaesthesia and especially for patients weighing less than 30 kgs, so for dynamics rapid cells growth and or elderly patients suffering of rapid dynamic death cells. TCI systems used for the management of paediatric and neonatal anaesthesia, i.e. Paedfusor TCI by Absalom-Lal-Kenny et al (2005), needed further investigation for their use in younger patients. There is a lack of body functioning and pharmacological data in the paediatric and neonatal population that need to be integrated in a new program to be installed in computer-driven anaesthesia systems. A new theoretical pathway and speculation about the approach to applied pharmacology is compulsory. But as new theoretical “pharmacodynamics-pharmacokinetic” (PK/PD) concept and covariates choices are required to be settled in the systems; a new scientific approach is required. Our theoretical speculations and practical mathematical proposal takes into consideration different covariate factors and is based not only on the theoretical consideration that drove to “Gepts thricompartimental equation” concept, but would like to considers the aid of “allometry” growth pharmacological laws and equations and insert the concepts in a sort of “Quantic Pharmacology” new research pathway. We want to argue if the way we look at such a complex approach is correct, and if it could be applicable, and better defines and use novel data to improve the “Gepts” equation related to the neonatal-paediatric-elderly age range.