Pharmacokinetics parameters of drugs in the treatment of critically ill patients Kanade TAKAGI 1 , Mikihiro MAEDA 1 1Department of Pharmacy St. Marianna University School of Medicine Hospital pp.229-238
Published Date 2021/4/1
DOI https://doi.org/10.11477/mf.3102200855
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Critically ill patients require treatment with a variety of drugs, including sedatives, analgesics, antibiotics, and antiepileptic drugs. Pharmacokinetic parameters of drugs used to treat critically ill patients are modulated by multiple factors, including fluid resuscitation, the presence of multiple organ dysfunction and/or comorbidities. It is important to understand how a drug is affected by absorption, distribution, metabolism, and elimination in order to guide administration to individual patients considering safety and efficacy. In drug absorption, we discuss the impact of vasopressor use and delayed gastric emptying. On the topic of drug distribution, we review the impact of increased volume of distribution and alterations in plasma protein binding. With drug metabolism, we discuss hepatic enzyme activity, protein binding, and hepatic blood flow. Finally, we review drug elimination in the critically ill patient and discuss the impact of augmented renal clearance.

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