Pharmacokinetics and pharmacodynamics in the critically ill patient.
1. Until recently, when drugs were used in critically ill patients they were expected to behave in the same way as in less seriously ill patients. Now the unpredictability of even the most reliable drugs has been recognized. With this there is an awareness of the adverse effects drugs may have on organs other than the ones the drug was intended to act on. In patients with multiorgan dysfunction, poly-pharmacy is usually needed. The drugs may not only interfere with the action of each other at the receptor and enzyme level, but may also change protein binding and elimination. All these effects may be unimportant in less seriously ill patients, but may affect outcome in the critically ill. A high degree of awareness and suspicion of unknown drug-induced adverse reaction is needed by clinicians and pharmacologists alike.
Park
G R
GR
John Farman Intensive Care Unit, Addenbrooke's NHS Trust, Cambridge, UK.
D016638:Critical Illness; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008099:Liver / Q000378:metabolism; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000378:metabolism; D010599:Pharmacokinetics; D010600:Pharmacology; D011955:Receptors, Drug / Q000378:metabolism; D012131:Respiratory Insufficiency; D012720:Severity of Illness Index; D012997:Solvents / Q000494:pharmacology
D004364:Pharmaceutical Preparations; D011955:Receptors, Drug; D012997:Solvents