RT Book, Section
A1 Krishnan, Vidya
A1 Corbridge, Thomas
A1 Murray, Patrick
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Wood, Lawrence D.H.
SR Print(0)
ID 2281260
T1 Chapter 103. Critical Care Pharmacology
T2 Principles of Critical Care, 3e
YR 2005
FD 2005
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071416405
LK accessmedicine.mhmedical.com/content.aspx?aid=2281260
RD 2022/08/12
AB Critical  care  therapeutics  should  be  individualized  to  maximize  therapeutic  effect  while  minimizing  the  potential  for  adverse  drug  reactions.The  appropriate  loading  dose  is  determined  primarily  by  the  volume  of  distribution  of  the  drug  in  the  patient.The  maintenance  dose  is  proportional  to  the  clearance  and  the  desired  steady-state  plasma  concentration.Elimination  half-life  is  inversely  proportional  to  clearance  and  directly  proportional  to  volume  of  distribution.Steady-state  conditions  are  obtained  after  the  passage  of  three  to  five  half-lives.Prospective  consideration  of  possible  drug-patient,  drug-disease,  and  drug-drug  interactions  minimizes  the  potential  for  undertreatment  or  adverse  drug  reactions.Therapeutic  drug  monitoring  may  follow  purely  pharmacodynamic  parameters  or  additionally  use  plasma  levels  to  calculate  pharmacokinetic  parameters.Therapeutic  drug  monitoring  attempts  to  ensure  adequate  therapy  and  to  prevent,  detect,  and  appropriately  report  adverse  drug  reactions.Systemwide  changes  in  management  of  critically  ill  patients,  including  physician  order  entry  systems  and  dedicated  intensivists  and  pharmacists,  can  potentially  decrease  the  incidence  of  adverse  drug  reactions.