Pharmacology of commonly used analgesics and sedatives in the ICU: benzodiazepines, propofol, and opioids.
Opioids, benzodiazepines, and propofol remain the mainstay by which to optimize patient comfort and facilitate mechanical ventilation in patients who are critically ill. Unfortunately none of these agents share all of the characteristics of the ideal sedative or analgesic agent: rapid onset, rapid recovery, a predictable dose response, a lack of drug accumulation, and no toxicity. To optimize care, critical care clinicians should be familiar with the many pharmacokinetic, pharmacodynamic, and pharmacogenetic variables that can affect the safety and efficacy of these sedatives and analgesics.
Devlin
John W
JW
Northeastern University School of Pharmacy, MU206, 360 Huntington Avenue, Boston, MA 02115, USA. j.devlin@neu.edu
Roberts
Russel J
RJ
D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D007362:Intensive Care Units; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D012121:Respiration, Artificial / Q000379:methods*
D000700:Analgesics; D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D015742:Propofol