Hilgarth H, Baehr M, Kluge S, König C
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Klinikapotheke, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Med Klin Intensivmed Notfmed. 2021 Mar;116(2):173-184. doi: 10.1007/s00063-020-00767-z. Epub 2021 Feb 2.
Adequate pharmacotherapy in critically ill patients is challenging for many clinicians. Disease-related pathophysiological changes often lead to complex therapy strategies including many intensive care treatments (e.g. invasive ventilation, renal replacement therapy). These measures often influence drug prescribing and dosing. Therefore, in organ dysfunction such as renal and liver impairment reduced drug elimination has to be considered by adapting drug dosing towards elimination rates. Moreover, as intensive care medicine often includes the use of multiple drugs the risk for drug-drug interactions increases. The current article gives an overview about the complexity of individual pharmacotherapy in intensive care units whilst providing information for its clinical implementation.
对许多临床医生来说，为重症患者提供充分的药物治疗具有挑战性。与疾病相关的病理生理变化常常导致复杂的治疗策略，包括许多重症监护治疗（如有创通气、肾脏替代治疗）。这些措施常常影响药物的处方和剂量。因此，在出现肾脏和肝脏损害等器官功能障碍时，必须通过根据消除率调整药物剂量来考虑药物消除减少的情况。此外，由于重症医学经常涉及多种药物的使用，药物相互作用的风险增加。本文概述了重症监护病房个体化药物治疗的复杂性，同时提供了其临床实施的相关信息。
