Review on Pharmacokinetic Modeling and the Effects of Environmental Stressors on Pharmacokinetics for Operational Medicine: Operational Pharmacokinetics

摘要

In this report, we conducted a comprehensive literature review on the effects of a range of physiological and psychological stressors on drug absorption, distribution and elimination (pharmacokinetics), and current pharmacokinetic models (including computerized modeling tools and algorithms) used to predict pharmacokinetic changes. Although sophisticated computerized mathematical models have been widely used to quantitatively describe the pharmacokinetics of drugs in the human body, limited experimental data for both descriptive and predictive purposes were available. The effects of isolated physical activities on pharmacokinetics have been documented. However, some inconsistencies need to be addressed, such as the intensity and duration of each physical activity, and timing of drug administration. Other physiological stressors, such as temperature, hypoxic, hyperbaric and hyperoxic conditions have been studied to a lesser extent. There are only a few reports describing the psychological effects on drug pharmacokinetics. After carefully reviewing the literature, our goal is to develop a physiologically-based pharmacokinetic model to predict the absorption, distribution and elimination of drugs employed under various military physiological and psychological stressors.