title: Pharmacoeconomic issues of sedation, analgesia, and neuromuscular blockade in critical care.
abstract: Neuromuscular blocking agents (NMBAs) are commonly prescribed as adjunct therapy for many critically ill patients. Controversy exists regarding the appropriate long-term use of these agents, particularly since there are severe potential clinical consequences. The expanded use of NMBAs has had a significant effect on the cost of ICU care. One should determine whether or not NMBAs are being used as adjunct therapy, or as a replacement for optimal sedation and/or analgesia. This article reviews some of the indicative economic issues surrounding the use of sedatives, analgesics, and NMBAs in the critical care arena. Understanding the pharmacokinetic and pharmacodynamic differences of these agents can aid in drug selection and route of administration. Appropriate drug selection can influence the pharmacoeconomics of these agents in the ICU.
authors.affiliation: Department of Pharmacy, Mission Hospital Regional Medical Center, CA 92691.
authors.forename: D K
authors.initials: DK
authors.lastname: Armstrong
authors.forename: C B
authors.initials: CB
authors.lastname: Crisp
mesh_terms: D000698:Analgesia / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D016292:Procedural Sedation / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D003363:Cost Control; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D016638:Critical Illness / Q000191:economics / Q000628:therapy; D016527:Drug Costs / Q000706:statistics & numerical data*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D009466:Neuromuscular Blocking Agents / Q000191:economics* / Q000494:pharmacology / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000009:adverse effects; D013997:Time Factors
chemical_list: D009466:Neuromuscular Blocking Agents