Corbett Stephanie Mallow, Rebuck Jill A
University of Houston College of Pharmacy and The Methodist Hospital, Houston, Texas, USA.
J Intensive Care Med. 2008 Mar-Apr;23(2):91-108. doi: 10.1177/0885066607312966.
Trauma patients are twice as likely to have adverse reactions to medication as nontrauma patients. The need for medication in trauma patients is high. Surgery is often necessary, and immunosuppression and hypercoagulability may be present. Adverse drug events can be caused in part by altered pharmacokinetics, drug interactions, and polypharmacy. Medications may also have serious long-term adverse effects, which must be considered. It is not the purpose of this review article to discuss all adverse effects of all medications. This article will discuss the more common adverse effects of medications for trauma patients in the acute care setting, in the following categories: pain control, sedation, antibiotics, seizure prophylaxis in head trauma, atrial fibrillation, deep vein thrombosis and pulmonary embolism prophylaxis, hemodynamic support, adrenal insufficiency, factor VIIa.
创伤患者出现药物不良反应的可能性是非创伤患者的两倍。创伤患者对药物的需求很高。通常需要进行手术,且可能存在免疫抑制和高凝状态。药物不良事件部分可能由药代动力学改变、药物相互作用和多药合用引起。药物也可能有严重的长期不良反应,必须予以考虑。本综述文章的目的不是讨论所有药物的所有不良反应。本文将讨论急性护理环境中创伤患者使用药物时更常见的不良反应,分为以下几类:疼痛控制、镇静、抗生素、颅脑创伤中的癫痫预防、心房颤动、深静脉血栓形成和肺栓塞预防、血流动力学支持、肾上腺功能不全、凝血因子VIIa。