RT Book, Section A1 Bauer, Seth R. A1 Dzierba, Amy L. A2 Schmidt, Gregory A. A2 Kress, John P. A2 Douglas, Ivor S. SR Print(0) ID 1201812089 T1 Drug Dosing and Monitoring in the Critically Ill and Injured Patient T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition YR 2023 FD 2023 PB McGraw Hill PP New York, NY SN 9781264264353 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1201812089 RD 2024/10/13 AB KEY POINTSMedication dosages are typically titrated to the intended effect, with an intravenous administration strategy selected based on the medication properties and goals of therapy.Drug volume of distribution is often increased in critically ill patients necessitating the use of initial loading doses to quickly achieve therapeutic drug concentrations.Pharmacokinetic changes evolve throughout a patient’s illness course requiring frequent reassessment and refinement of dosage regimens.Therapeutic drug monitoring can improve dosage optimization but should be reserved for patient populations with significant pharmacokinetic variability.Patients with acute kidney injury should have initial normal (nonadjusted) medication dosage regimens with subsequent modification based on renal injury progression, including the initiation or cessation of continuous renal replacement therapy.Clinicians should thoroughly evaluate each medication during transitions of care in order to stop unnecessary therapies.