title: Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit.
abstract: Since the 2002 publication of multidisciplinary clinical practice guidelines for intensive care unit (ICU) sedation and analgesia, additional information regarding adverse drug events has been reported. Our understanding of the risks associated with these sedative and analgesic agents promises to improve outcomes by helping clinicians identify and respond to therapeutic misadventures sooner. This review focuses on many issues, including the potentially fatal consequences associated with the propofol infusion syndrome, the evolving understanding of propylene glycol intoxication associated with parenteral lorazepam, new data involving high-dose and long-term dexmedetomidine therapy, haloperidol- and methadone-related prolongation of QTc intervals on the electrocardiogram, adverse events associated with atypical antipsychotics, and the potential for nonsteroidal antiinflammatory drugs to interfere with bone healing.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Maine Medical Center, Portland, Maine 04102, USA.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Riker
authors.forename: Gilles L
authors.initials: GL
authors.lastname: Fraser
mesh_terms: D000138:Acidosis / Q000139:chemically induced*; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced*; D002648:Child; D016292:Procedural Sedation; D003693:Delirium / Q000139:chemically induced*; D004334:Drug Administration Schedule; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007022:Hypotension / Q000139:chemically induced*; D007362:Intensive Care Units; D016171:Torsades de Pointes / Q000139:chemically induced
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives