Anesthetic drug interaction: an overview.
Modern anesthetic techniques involve combinations of intravenous (i.v.) and inhaled anesthetic drugs that may produce synergistic (supraadditive), additive, or antagonistic interactions. Synergistic interaction is most likely to occur when two or more drugs produce similar effects by different mechanisms. All of the tested combinations of opioids and i.v. sedative-hypnotics have been shown to produce synergistic hypnotic effects, and the majority of these interactions are predictable and useful in daily practice. Opioids, benzodiazepines, lidocaine, and alpha-2 agonists can all reduce the requirements for volatile anesthetics, but only the opioids and the alpha-2 agonists produce this effect at clinically acceptable concentrations. The usefulness of a drug interaction depends on whether it produces greater efficacy or reduced toxicity. Surprisingly, these outcomes have only been specifically measured for a handful of common drug combinations.
Rosow
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Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston 02114, USA.
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology; D000701:Analgesics, Opioid / Q000494:pharmacology; D019162:Anesthetics, Combined / Q000494:pharmacology*; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D014151:Anti-Anxiety Agents / Q000494:pharmacology; D001569:Benzodiazepines; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology
D000316:Adrenergic alpha-Agonists; D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines