Pharmacokinetics from a dynamical systems point of view.

The pharmacological action of many drugs depends on several variables at the same time and therefore will be dominated by an attractor of a dimension greater than zero. The pharmacokinetic behavior is likely to be dominated by a zero dimensional point attractor so that it is highly predictable. Pharmacokinetics is discussed from a dynamical systems point of view, whereby the transport of drugs in the tissues and organs is considered a stochastic process characterized by density functions of transit times and blood flows. In the body, the tissues and organs are arranged in parallel, in series, and in a feedback-loop fashion. Consequently, the single-pass transport of drugs through the body is again a stochastic process characterized by the density function of total body transit times, the cardiac output, and the total body extraction. The drug molecules, however, may pass through the body several times before ultimately leaving the system by metabolism or excretion. As a result, the body may be regarded as a positive feedback system with the pulmonary circulation (and its tissues) as the forward transfer function and the systemic circulation (with all its tissues) as the feedback transfer function. Consequently, the total body transport function (closed loop) is again a stochastic process characterized by a density function of total body residence times. The relationship between the body transit time distribution and the body residence distribution is determined by the feedback-loop arrangement, the cardiac output, and the extraction ratio which can easily be written in the Laplace domain. The pharmacokinetic parameters logically follow from the systems approach. They are the cardiac output, the mean transit time, the extraction ratio, the clearance, the volume of distribution in steady state, the mean residence time, and the average number of recirculations. The dynamic systems approach in pharmacokinetics has been illustrated with some examples notably with caffeine.