Modèles pharmacodynamiques : modèle concentration-effet logarithmique

The log-linear model describes the relationship between drug concentration and its effect by assuming the effect is directly proportional to the logarithm of drug concentration. It uses the equation E = S × log(C) + E0, where S represents the effect per unit concentration, C is plasma drug concentration, and E0 is baseline effect. This model is particularly useful when drug effects range between 20% and 80% of maximum effect.

The log-linear model is most applicable when observed drug effects fall between 20% and 80% of the maximum effect (Emax), where the relationship between log drug concentration and effect appears nearly linear. Within this range, the model accurately predicts concentration-effect relationships for drugs like warfarin and propranolol, making it valuable for understanding pharmacodynamic responses in clinical settings.

The log-linear model cannot predict the maximum possible effect (Emax) or the effect at zero drug concentration, limiting its applicability in complete pharmacodynamic analyses. These limitations mean the model is restricted to predicting concentration-effect relationships within the linear range and cannot extrapolate to extreme effect values or baseline conditions.

Propranolol demonstrates a linear concentration-effect relationship with exercise-induced tachycardia when plotted on a logarithmic scale. Increasing propranolol concentration effectively reduces tachycardia by blocking β-adrenergic receptors. The intravenous route produces more pronounced and consistent responses compared to oral administration due to reduced variability in bioavailability and plasma concentration.

Intravenous propranolol administration produces more consistent and pronounced responses because it avoids the variability associated with oral bioavailability and absorption. IV administration results in more predictable plasma concentrations, allowing the log-linear model to accurately describe the concentration-effect relationship. Oral routes introduce additional variables that reduce response consistency.

Warfarin and propranolol are primary examples of drugs effectively modeled using the log-linear approach. Both drugs demonstrate linear relationships between log plasma concentration and their pharmacological effects within the 20-80% Emax range. This makes the log-linear model particularly valuable for predicting and understanding the concentration-effect relationships of these commonly used medications.

The log-linear model assumes a linear relationship between log drug concentration and effect, differing from models that describe sigmoidal or non-linear relationships. Unlike the Emax model, the log-linear model cannot predict maximum effect or baseline response. It is specifically designed for the middle range of drug effects and provides a simplified approach to concentration-effect prediction within defined boundaries.