Aplicacion de los modelos pk/pd en ensayos pre clinicos y clinicos en analgesia

Résumé

Untreated or inadequately treated pain is one of the greatest medical problem in our society. severe or modérate pain in half of all hospital ized patients and in older people has significantly increased for long period of time. Even though our society has tools to treat most pain effectively, many people continué to suffer severe pain. Failure to treat pain adequately and effectively occurs because pain isa complex, subjective, perceptual pnenomenon or experience with a number of dimensions- intensity, quality, time course, impact, and personal meaning- that are uniquely experienced by each individual. Therefore, there is no way to objectivel y quantify pain so the treatment need to be individualized. in this fi el d, the population pharmacokinetic/pharmacodinamic (pk/pd) modeli ing approach could be an excellent tool. Having taken all this in account, the main objective of this study was to control the severe or modérate pain with an opioid of level II. One of greatest problems due to the multiterapy needed in the treatment of chronic Pain and that must to be faced when working with opioids treatment, is the hepàtic dysfunction. Opioids most commonly used in the treatment of pain (for example: morphine and tramadol), share a common characteristic,.the metabolite is the compound responsable of the antinociception effect. in this sense, a model which incorporates a li ver compartment, could be very useful to described drug and metabolite concentrations in cases where a liver dysfunction exist. Thus, dose adjustment could be improved with this model in special populations with alterations of the potential in metabòlic hepàtic function: (i) patient with hepàtic level metástasis and/or (ii) limit age sectors (newborn and elderly people).