TY - CHAP M1 - Book, Section TI - Chapter 103. Critical Care Pharmacology A1 - Krishnan, Vidya A1 - Corbridge, Thomas A1 - Murray, Patrick A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Wood, Lawrence D.H. PY - 2005 T2 - Principles of Critical Care, 3e AB - Critical care therapeutics should be individualized to maximize therapeutic effect while minimizing the potential for adverse drug reactions.The appropriate loading dose is determined primarily by the volume of distribution of the drug in the patient.The maintenance dose is proportional to the clearance and the desired steady-state plasma concentration.Elimination half-life is inversely proportional to clearance and directly proportional to volume of distribution.Steady-state conditions are obtained after the passage of three to five half-lives.Prospective consideration of possible drug-patient, drug-disease, and drug-drug interactions minimizes the potential for undertreatment or adverse drug reactions.Therapeutic drug monitoring may follow purely pharmacodynamic parameters or additionally use plasma levels to calculate pharmacokinetic parameters.Therapeutic drug monitoring attempts to ensure adequate therapy and to prevent, detect, and appropriately report adverse drug reactions.Systemwide changes in management of critically ill patients, including physician order entry systems and dedicated intensivists and pharmacists, can potentially decrease the incidence of adverse drug reactions. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2022/05/20 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=2281260 ER -