Pharmacokinetics and pharmacodynamics in critically ill patients. 2010

Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia.

OBJECTIVE The purpose of this review is to highlight the recently published studies in the area of pharmacokinetics and pharmacodynamics in critically ill patients and ascertain the relevance to clinical practice. RESULTS The majority of the published studies in this area were related to antibiotics and this will form the main focus of this review. A number of studies have focused on antibiotic concentrations at various target sites of infection or other tissue sites including cerebrospinal fluid, peritoneal fluid and burns tissues. The administration of time-dependent antibiotics using continuous infusion has also been the subject of recently published studies which support the superior achievement of pharmacodynamic targets using continuous infusion compared with bolus dosing. Antibiotic dosing during renal replacement therapies, mainly during extended daily dialysis (EDD) and during other forms of extracorporeal techniques including extracorporeal membrane oxygenation (ECMO), have also been described in a few recent studies and case reports. CONCLUSIONS Studies have shown that critically ill patients display large variations in pharmacokinetics mainly due to altered pathophysiology. An understanding of the pathophysiological changes that occur in critically ill patients is essential to optimize dosing particularly to achieve the pharmacodynamic targets for antibiotics.

UI MeSH Term Description Entries
D010599 Pharmacokinetics Dynamic and kinetic mechanisms of exogenous chemical DRUG LIBERATION; ABSORPTION; BIOLOGICAL TRANSPORT; TISSUE DISTRIBUTION; BIOTRANSFORMATION; elimination; and DRUG TOXICITY as a function of dosage, and rate of METABOLISM. LADMER, ADME and ADMET are abbreviations for liberation, absorption, distribution, metabolism, elimination, and toxicology. ADME,ADME-Tox,ADMET,Absorption, Distribution, Metabolism, Elimination, and Toxicology,Absorption, Distribution, Metabolism, and Elimination,Drug Kinetics,Kinetics, Drug,LADMER,Liberation, Absorption, Distribution, Metabolism, Elimination, and Response
D004364 Pharmaceutical Preparations Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. Drug,Drugs,Pharmaceutical,Pharmaceutical Preparation,Pharmaceutical Product,Pharmaceutic Preparations,Pharmaceutical Products,Pharmaceuticals,Preparations, Pharmaceutical,Preparation, Pharmaceutical,Preparations, Pharmaceutic,Product, Pharmaceutical,Products, Pharmaceutical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D015199 Extracorporeal Membrane Oxygenation Application of a life support system that circulates the blood through an oxygenating system, which may consist of a pump, a membrane oxygenator, and a heat exchanger. Examples of its use are to assist victims of SMOKE INHALATION INJURY; RESPIRATORY FAILURE; and CARDIAC FAILURE. ECMO Extracorporeal Membrane Oxygenation,Oxygenation, Extracorporeal Membrane,Venoarterial ECMO,Venoarterial Extracorporeal Membrane Oxygenation,Venovenous ECMO,Venovenous Extracorporeal Membrane Oxygenation,ECLS Treatment,ECMO Treatment,Extracorporeal Life Support,ECLS Treatments,ECMO Treatments,ECMO, Venoarterial,ECMO, Venovenous,Extracorporeal Life Supports,Extracorporeal Membrane Oxygenations,Life Support, Extracorporeal,Membrane Oxygenation, Extracorporeal,Treatment, ECLS,Treatment, ECMO,Venoarterial ECMOs,Venovenous ECMOs
D016638 Critical Illness A disease or state in which death is possible or imminent. Critically Ill,Critical Illnesses,Illness, Critical,Illnesses, Critical
D017582 Renal Replacement Therapy Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys. Kidney Replacement Therapy,Replacement Therapy, Kidney,Replacement Therapy, Renal,Therapy, Kidney Replacement,Therapy, Renal Replacement,Kidney Replacement Therapies,Renal Replacement Therapies,Replacement Therapies, Kidney,Replacement Therapies, Renal,Therapies, Kidney Replacement,Therapies, Renal Replacement

Related Publications

Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
April 1987, World journal of surgery,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
February 2002, International journal of antimicrobial agents,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
January 2018, Surgical infections,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
August 2016, Drugs,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
November 1998, Journal of clinical pharmacology,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
November 1993, Xenobiotica; the fate of foreign compounds in biological systems,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
June 2008, Pediatric clinics of North America,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
January 2021, Antimicrobial agents and chemotherapy,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
March 2022, Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria,
Julie M Varghese, and Jason A Roberts, and Jeffrey Lipman
April 2001, Critical care medicine,
Copied contents to your clipboard!