Designing drug regimens for special intensive care unit populations

作     者：Brian L Erstad 

作者机构：Department of Pharmacy Practice and ScienceUniversity of Arizona College of Pharmacy 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2015年第4卷第2期

页      码：139-151页

摘      要：This review is intended to help clinicians design drug regimens for special populations of critically ill patients with extremes of body size, habitus and composition that make drug choice or dosing particularly challenging due to the lack of high-level evidence on which to make wellinformed clinical decisions. The data sources included a literature search of MEDLINE and EMBASE with reviews of reference lists of retrieved articles. Abstracts of original research investigations and review papers were reviewed for their relevance to drug choice or dosing in the following special critically ill populations: patients with more severeforms of bodyweight or height, patients with amputations or missing limbs, pregnant patients, and patients undergoing extracorporeal membrane oxygenation or plasma exchange. Relevant papers were retrieved and evaluated, and their associated reference lists were reviewed for citations that may have been missed through the electronic search strategy. Relevant original research investigations and review papers that could be used to formulate general principles for drug choice or dosing in special populations of critically ill patients were extracted. Randomized studies with clinically relevant endpoints were not available for performing quantitative analyses. Critically ill patients with changes in body size, habitus and composition require special consideration when designing medication regimens, but there is a paucity of literature on which to make drug-specific, high-level evidencebased recommendations. Based on the evidence that is available, general recommendations are provided for drug choice or dosing in special critically ill populations.

主 题 词：Drug dosage calculations Pharmacokinetics Critical care Body composition Obesity Pregnancy 

学科分类：1007[医学-药学类] 10[医学] 

D　O　I：10.5492/wjccm.v4.i2.139

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