title: The effect of halothane on the recirculatory pharmacokinetics of physiologic markers.
abstract: BACKGROUND
  The cardiovascular effects of halothane are well recognized, but little is known of how this affects drug distribution. The effect of halothane anesthesia on physiologic factors that affect drug disposition from the moment of injection was investigated.
  
  
  METHODS
  The dispositions of markers of intravascular space and blood flow (indocyanine green), extracellular space and free water diffusion (inulin), and total body water and tissue perfusion (antipyrine) were determined in four purpose-bred coonhounds. The dogs were studied while awake and while anesthetized with 1%, 1.5%, and 2% halothane in a randomized order determined by a repeated measures Latin square experimental design. Marker dispositions were described by recirculatory pharmacokinetic models based on frequent early and less frequent later arterial blood samples. These models characterize the role of cardiac output and its distribution on drug disposition.
  
  
  RESULTS
  Halothane caused a significant and dose-dependent decrease in cardiac output. The disposition of antipyrine was most profoundly affected by halothane anesthesia, which increased both nondistributive intercompartmental clearance and volume while decreasing fast and slow tissue clearances and elimination clearance in a halothane dose-dependent manner.
  
  
  CONCLUSIONS
  Halothane-induced changes in blood flow to the compartments of the antipyrine recirculatory model were not proportional to changes in cardiac output. Halothane anesthesia significantly increased (to more than double) the area under the drug concentration versus time curve due to an increase in the apparent peripheral blood flow not involved in drug distribution, despite a dose-dependent cardiac output decrease. Recirculatory pharmacokinetic models include the best aspects of traditional compartmental and physiologic pharmacokinetic models while offering advantages over both.
authors.affiliation: Northwestern University Medical School Department of Anesthesiology, Chicago, Illinois 60611-3008, USA. mja190@nwu.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Avram
authors.forename: T C
authors.initials: TC
authors.lastname: Krejcie
authors.forename: C U
authors.initials: CU
authors.lastname: Niemann
authors.forename: C
authors.initials: C
authors.lastname: Klein
authors.forename: W B
authors.initials: WB
authors.lastname: Gentry
authors.forename: C A
authors.initials: CA
authors.lastname: Shanks
authors.forename: T K
authors.initials: TK
authors.lastname: Henthorn
mesh_terms: D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000097:blood / Q000493:pharmacokinetics*; D000983:Antipyrine / Q000097:blood / Q000493:pharmacokinetics*; D019540:Area Under Curve; D004396:Coloring Agents / Q000493:pharmacokinetics; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D006221:Halothane / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D007208:Indocyanine Green / Q000493:pharmacokinetics; D007444:Inulin / Q000097:blood / Q000493:pharmacokinetics*; D008297:Male; D014018:Tissue Distribution
chemical_list: D018685:Anesthetics, Inhalation; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004396:Coloring Agents; D007444:Inulin; D007208:Indocyanine Green; D000983:Antipyrine; D006221:Halothane