Is Synergy the Rule? A Review of Anesthetic Interactions Producing Hypnosis and Immobility

@article{Hendrickx2008IsST,
  title={Is Synergy the Rule? A Review of Anesthetic Interactions Producing Hypnosis and Immobility},
  author={Jan F. A. Hendrickx and Edmond I. Eger and James M. Sonner and Steven L. Shafer},
  journal={Anesthesia \& Analgesia},
  year={2008},
  volume={107},
  pages={494-506}
}
BACKGROUND: Drug interactions may reveal mechanisms of drug action: additive interactions suggest a common site of action, and synergistic interactions suggest different sites of action. We applied this reasoning in a review of published data on anesthetic drug interactions for the end-points of hypnosis and immobility. METHODS: We searched Medline for all manuscripts listing propofol, etomidate, methohexital, thiopental, midazolam, diazepam, ketamine, dexmedetomidine, clonidine, morphine… Expand
Clinically Significant Interactions with Anesthetic Agents
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Opioids, lidocaine, NSAIDs, maropitant, acepromazine, and NMDA antagonists have been shown to reduce the MAC of inhaled anesthetics in dogs and allow for clinically important decreases in inhalant anesthetic use. Expand
Dexmedetomidine and hydroxyzine synergistically potentiate the hypnotic activity of propofol in mice
PurposeInvestigation into the characteristics of anesthetic interactions may provide clues to anesthesia mechanisms. Dexmedetomidine, an α2-adrenergic receptor agonist, has become a popular sedativeExpand
Minimum alveolar concentration: Key concepts and a review of its pharmacological reduction in dogs. Part 1.
TLDR
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When Duzitol does not do it all: the two sides of drug synergy.
TLDR
In their analysis of the literature on anesthetic drug interactions, Hendrickx et al. concluded that opioids interact synergistically with not only volatile anesthetics but also IV-administered hypnotics. Expand
General Anesthetics Have Additive Actions on Three Ligand Gated Ion Channels
TLDR
The simultaneous allosteric modulation of ligand gated ion channels by general anesthetics is entirely additive, thus demonstrating the existence of multiple intraprotein anesthetic binding sites. Expand
Additivity Versus Synergy: A Theoretical Analysis of Implications for Anesthetic Mechanisms
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Additivity among drugs acting on different receptors is only likely if the concentrations responsible for the drug effect of interest are well below the concentration associated with 50% receptor occupancy. Expand
Pharmacodynamic Interaction of Remifentanil and Dexmedetomidine on Depth of Sedation and Tolerance of Laryngoscopy.
TLDR
A three-phase crossover trial to study the pharmacodynamic interaction between remifentanil and dexmedetomidine in 30 age- and sex-stratified healthy volunteers found that, despite falling asleep, most subjects remained arousable by calling the subject's name, shaking the subject while shouting their name, or a trapezius squeeze, even after reaching supraclinical concentrations. Expand
Synergistic antinociception of propofol–alfentanil combination in mice
  • Yin Wu, Na Jia, +7 authors A. Wen
  • Medicine
  • Pharmacology Biochemistry and Behavior
  • 2014
TLDR
The data suggest that the combination of alfentanil and propofol synergistically suppresses acute phasic and tonic pain in mice, indicating a potential application in pain treatment. Expand
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