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from Section 4 - Therapeutic Interventions and Organ Support
Published online by Cambridge University Press: 27 July 2023
Key Learning Points
1. Understanding how the patient will handle a drug (pharmacokinetics) and how the drug will affect the patient (pharmacodynamics) is crucial to prescribing any drug safely.
2. It is important to consider both how the drugs may interact with other drugs being co-administered and how their effect/handling may be affected by the patient’s critical illness and associated organ dysfunction.
3. The loading dose, repeat doses and/or dosing interval may need to be adjusted, and in some cases monitoring of drug levels may be possible/necessary.
4. Critical illness is a rapidly changing dynamic state. Daily medication chart review, considering if drugs are still indicated and/or if their dosing needs reviewing, depending on the changing clinical condition of the patient, is essential.
5. Prescribing in critical illness can be a complex area; however, there are comprehensive resources available to guide practice. Seeking support and advice from your pharmacist when in doubt is a very useful and sensible approach.
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