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British Journal of Anaesthesia, 2003, Vol. 91, No. 1 50-60
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Drug handling by the lungs

F. Boer

Department of Anaesthesiology, P5-Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands E-mail: f.boer@lumc.nl

Keywords: anaesthetics i.v.; anaesthetics local; lung, metabolic function

The first 150 words of the full text of this article appear below.

The lungs are pharmacologically active organs and affect the blood concentrations of drugs given intravenously. The lungs can take up, retain, metabolize and delay the release of many drugs and compounds. The ability of the lungs to remove endogenous compounds from the pulmonary arterial blood was recognized in the 1960s.112 The chemicals and drugs that are preferentially taken up by the lungs have diverse chemical structures and pharmacological activities. Philpot82 noted that compounds with significant pulmonary uptake were basic amines with pKa values >8. Although not limited to such compounds, pulmonary uptake is most relevant for drugs with these characteristics. Many of the drugs used in anaesthesia are basic amines, and the pulmonary uptake of anaesthetics has attracted the interest of anaesthetists. This review describes how the pharmacokinetic function of the lungs can be studied, which anaesthetics are taken up by the lungs, how the pharmacokinetic function of the . . . [Full Text of this Article]

Methods of investigation

Pulmonary uptake of individual drugs

Lidocaine and other local anaesthetics

Opioids

Induction agents

Muscle relaxants

Catecholamines

Propranolol

Factors influencing the pulmonary uptake of drugs

Mechanisms of pulmonary uptake

Incorporating lung uptake of drugs into pharmacokinetic models

Conclusions


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