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Drug interactions icu

Christoph Töpper, Cathérine L Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. Intensive care unit (ICU) patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. METHODS: Plasma concentrations of linezolid were determined by high-performance liquid chromatography in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily...
October 2016: Therapeutic Drug Monitoring
S J Kelly, J L Moran, P J Williams, K Burns, A Rowland, J O Miners, S L Peake
Paracetamol is a commonly used drug in the intensive care unit. There have been reports in the literature of an association with significant hypotension, a potentially important interaction for labile critically ill patients. Route of administration may influence the incidence of hypotension. This single-centre, prospective, open-label, randomised, parallel-arm, active-control trial was designed to determine the incidence of hypotension following the administration of paracetamol to critically ill patients...
October 2016: Anaesthesia
Amartya Mukhopadhyay, Jeyakumar Henry, Venetia Ong, Claudia Shu-Fen Leong, Ai Ling Teh, Rob M van Dam, Yanika Kowitlawakul
BACKGROUND & AIMS: For patients in the intensive care unit (ICU), nutritional risk assessment is often difficult. Traditional scoring systems cannot be used for patients who are sedated or unconscious since they are unable to provide information on their history of food intake and weight loss. We aim to validate the NUTRIC (NUTrition RIsk in Critically ill) score, an ICU-specific nutrition risk assessment tool in Asian patients. METHODS: This was an observational study in the medical ICU of a university-affiliated tertiary hospital...
August 12, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Medine Gülçebi İdriz Oğlu, Esra Küçükibrahimoğlu, Atila Karaalp, Özlem Sarikaya, Mahluga Demirkapu, Filiz Onat, Mehmet Zafer Gören
BACKGROUND/AIM: Drug-drug interactions (DDIs) can impact patient safety. Occurrence of clinically important DDIs is higher for intensive care unit (ICU) patients. This observational study aimed to evaluate the potential DDIs in medical ICU patients of a university hospital. MATERIALS AND METHODS: The Medical Pharmacology Department organized consultation reports for ICU patients in order to detect the DDIs. To focus on clinically important DDIs, interactions in the C, D, or X risk rating categories of the Lexi-Interact online database were analyzed...
2016: Turkish Journal of Medical Sciences
Deborah Dudgeon, Vickie E Baracos
PURPOSE OF REVIEW: Loss of skeletal muscle mass and cachexia are important manifestations of chronic obstructive pulmonary disease and have been associated with breathlessness, functional limitation and poor prognosis. A number of other life-limiting illnesses, including cancer and chronic heart failure as well as acute conditions seen in ICU such as sepsis, are characteristically associated with cachexia and sarcopenia. These conditions may have respiratory muscle atrophy of sufficient magnitude to contribute to the development of breathlessness and associated functional limitation...
September 2016: Current Opinion in Supportive and Palliative Care
Mohammad Ismail, Farmanullah Khan, Sidra Noor, Iqbal Haider, Inam-Ul Haq, Zahid Ali, Zahir Shah, Mohsin Hassam
Background Patients admitted to intensive care unit (ICU) present with severe and life-threatening illnesses. Most of them suffer from various comorbidities. They usually receive complex pharmacotherapy with large number of medicines which increase the risk of drug-drug interactions (DDIs). Objective The present report aimed to investigate prevalence and levels of potential DDIs (pDDIs) in medical ICU. Methods Medications profiles of 416 patients were checked for pDDIs using Micromedex Drug-Reax(®). Prevalence, levels of severity and levels of documentation were reported...
October 2016: International Journal of Clinical Pharmacy
Kent Doi
Acute kidney injury (AKI) is a common complication in critically ill patients treated in intensive care units. Renal replacement therapy (RRT)-requiring AKI occurs in approximately 5-10% patients in intensive care unit and their mortality rate is unacceptably high (50-60%), despite sufficient control of uremia using remarkably advanced modern RRT techniques. This suggests that there are unrecognized organ interactions following AKI that could worsen the outcomes. Cardiorenal syndrome has been defined based on clinical observations that acute and chronic heart failure causes kidney injury and AKI and that chronic kidney disease worsens heart diseases...
June 16, 2016: Nephron
W Grander
Malignant hyperthermia is a life-threatening disease caused by derangement of the autonomic nerve system and hypermetabolism of the peripheral musculature. Commonly body core temperatures of more than 40 °C will be found in this disease which is caused mostly by psychopharmacological drugs like antidepressants, neuroleptics but also antibiotics, pain killers, anti-Parkinson drugs, and volatile anesthetics. The inducers of malignant hyperthermia interact with postsynaptic receptors (serotonin, anticholinergics) or muscular intracellular structures responsible for calcium utilization (volatile anesthetics, succinylcholine)...
June 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Varsha Bhatt-Mehta
No abstract text is available yet for this article.
May 2016: Pediatric Critical Care Medicine
Aline Teotonio Rodrigues, Rebeca Stahlschmidt, Silvia Granja, Antonio Luis Eiras Falcão, Patricia Moriel, Priscila Gava Mazzola
PURPOSE: Evaluate the potential Drug-Drug Interactions (pDDI) found in prescription orders of adult Intensive Care Unit (ICU) of a Brazilian public health system hospital; quantify and qualify the pDDI regarding their severity and risks to the critical patient, using the database from Micromedex®. METHODS: Prospective study (January-December of 2011) collecting and evaluating 369 prescription orders (convenient sampling), one per patient. RESULTS: During the study 1844 pDDIs were identified and distributed in 405 pairs (medication A × medication B combination)...
September 2015: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Mollie Blazar Lebowitz, Karen L Olson, Michele Burns, Marvin B Harper, Florence Bourgeois
OBJECTIVES: Children treated with chronic medications are at risk of drug-drug interactions (DDIs) when hospitalized with an acute illness and prescribed new medications. We aimed to measure the prevalence of potential DDIs (pDDIs) among hospitalized children treated with antiepileptic drugs (AEDs) and to evaluate the impact of computerized physician order entry (CPOE) on pDDIs. METHODS: We analyzed a national sample of pediatric hospitalizations from 2005 to 2012 associated with administration of an AED and identified those prescribed a second medication with risk of a DDI...
May 2016: Hospital Pediatrics
Mohamed Hisham, Mudalipalayam N Sivakumar, Ganesh Veerasekar
BACKGROUND AND OBJECTIVES: A critically ill patient is treated and reviewed by physicians from different specialties; hence, polypharmacy is a very common. This study was conducted to assess the impact and effectiveness of having a clinical pharmacist in an Indian Intensive Care Unit (ICU). It also evaluates the clinical pharmacist interventions with a focus on optimizing the quality of pharmacotherapy and patient safety. MATERIALS AND METHODS: The prospective, observational study was carried out in medical and surgical/trauma ICU over a period of 1 year...
February 2016: Indian Journal of Critical Care Medicine
Roger Jelliffe
Acutely ill intensive care unit (ICU) patients often have large apparent volumes of distribution of drugs and, because of this, their drug clearance (CL) is usually also increased. 'Augmented renal Cl' is a current issue in the management of drug therapy for acutely ill and unstable ICU patients; however, Cl, the product of volume and the rate constant for excretion, describes only a theoretical volume of drug cleared per unit of time. Information of the actual rate of movement of the drug itself is obscured...
August 2016: Clinical Pharmacokinetics
Lukas Buendgens, Alexander Koch, Frank Tacke
Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU...
February 4, 2016: World Journal of Critical Care Medicine
Mariana Macedo Alvim, Lidiane Ayres da Silva, Isabel Cristina Gonçalves Leite, Marcelo Silva Silvério
OBJECTIVE: To evaluate the incidence of potential drug-drug interactions in an intensive care unit of a hospital, focusing on antimicrobial drugs. METHODS: This cross-sectional study analyzed electronic prescriptions of patients admitted to the intensive care unit of a teaching hospital between January 1 and March 31, 2014 and assessed potential drug-drug interactions associated with antimicrobial drugs. Antimicrobial drug consumption levels were expressed in daily doses per 100 patient-days...
October 2015: Revista Brasileira de Terapia Intensiva
Shadi Baniasadi, Behrooz Farzanegan, Maryam Alehashem
BACKGROUND: Patients in the intensive care unit (ICU) are more prone to drug-drug interactions (DDIs). The software and charts that indicate all interactions may not be proper for clinical usage. This study aimed to identify the main drug classes associated with clinically significant DDIs in cardiothoracic ICU and categorize DDIs to make cardiothoracic intensivists aware of safe medication usage. METHODS: This prospective study was conducted over 6 months in a cardiothoracic ICU of a university-affiliated teaching hospital...
December 2015: Annals of Intensive Care
Kelly Dowhower Karpa, Peter R Lewis, Todd Matthew Felix
Adverse drug reactions (ADRs) contribute to substantial morbidity and mortality and add to rising health care costs. Many ADRs are preventable with appropriate prescribing and monitoring because they often occur as an extension of a drug's mechanism of action or known drug interactions. Patients at higher risk of ADRs include those at the extremes of age, those with multiple comorbidities, those taking multiple drugs, and patients admitted to intensive care units or experiencing transitions of care. Because the risk of ADRs becomes greater as the number of drugs and dietary supplements taken increases, it is imperative that prescribers be vigilant about the prescribing cascade and take steps to discontinue drugs that are likely to be more harmful than helpful...
September 2015: FP Essentials
Sten Schubert, Martina Patrizia Neininger, Stefan Smers, Alfred Winter, Roberto Frontini, Astrid Bertsche, Thilo Bertsche
In tertiary care, computerized physician order entries may improve performance, cross-linking, and documentation when prescribing drugs. A clinical decision support integrated in these systems is discussed to prevent additional medication errors. For an optimal performance, the implementation into the clinical information systems is required to gain access to patient data (e. g. from laboratory). In routine care, the question rises whether a benefit of the systems can be proven in clinical studies and whether there is a difference between the systems...
June 2015: Medizinische Monatsschrift Für Pharmazeuten
Muhammad Asim Rana, Ahmed Fouad Mady, Basheer Abdel Rehman, Abdulrahman Alharthy, Basim Huwait, Asim Riaz, Waleed Tharwat Aletreby
Timolol Maleate (also called Timolol) is a nonselective beta-adrenergic blocker and a class II antiarrhythmic drug, which is used to treat intraocular hypertension. It has been reported to cause systemic side effects especially in elderly patients with other comorbidities. These side effects are due to systemic absorption of the drug and it is known that Timolol is measurable in the serum following ophthalmic use. Chances of life threatening side effects increase if these are coprescribed with other cardiodepressant drugs like calcium channel or systemic beta blockers...
2015: Case Reports in Critical Care
Michael J Samarin, Kerry M Mohrien, Carrie S Oliphant
The development of cardiac arrhythmias in the intensive care unit is common and associated with poor prognoses and outcomes. Because of the complexity of patients admitted to the intensive care unit, the management of arrhythmias is often difficult and may require multiple therapeutic interventions. In order for clinicians to appropriately manage arrhythmias, a thorough understanding of all available therapies, including intravenous antiarrhythmic agents, is essential. Suitable antiarrhythmic agents for use in the critical care setting include amiodarone, lidocaine, and procainamide...
October 2015: Critical Care Nursing Quarterly
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