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This interactive simulation of PK for fospropofol is based on a 5-compartment model from Fechner et al, Anesthesiology 99:303-13, 2003. Two compartments are used to model fospropofol PK
and three compartments for propofol PK, including a slow peripheral
compartment. Propofol administered alone can also be modeled simultaneously. Users can select either the Fechner (default)
or the Gepts model for propofol. Users can adjust the following
variables and visualize the essential effects of their interventions
on fospropofol and propofol concentration in any of the 5 compartments: weight,
infusion rate,infusion duration, dose of initial and second bolus
dose and timing of second bolus.
The first 5 variables can
be adjusted either by the slider bars or by placing the
cursor in the desired number field and manually entering numbers
from the keyboard. To adjust the timing of the second bolus of propofol or fospropofol,
click and drag the syringe icon representing the second bolus.
Plot parameters are also user-adjustable. The
range of time durations represented on the X axis can be 20 min,
1 hr, 6 hrs, 24 hrs and 48 hrs. The concentration values
on the Y axis can be plotted on a linear scale or a log 10 scale. The
Y-axis autoscale feature can be toggled off and the Y scale manually
adjusted, if desired.
By default, only the concentrations
in both propofol central compartments are plotted. To plot
concentration in other compartments, click on the “Plot” button
in the compartments. For sedation, the default values of the
user adjustable lower (ROC – recovery of response to verbal
command) and upper thresholds (LOC – loss of response to
verbal command) are 1.3 and 2.1 mg/L (mcg/ml).
Clicking on the
Genetic Polymorphism button generates different plots simulating
the variability between individual patients. The simulation,
once configured to the desired settings, can be saved by clicking
on the “Link to this simulation and settings” icon. This
will modify the URL in the address bar. Cut and paste that
modified URL into email, documents, Powerpoint files or web pages
so that the simulation initializes at the desired settings.