Pharmacotherapy

01.pdf......Page 1
Preface......Page 5
Physiologic role of vasopressin......Page 7
Clinical studies of vasopressin in shock......Page 9
Clinical studies of vasopressin in septic shock......Page 10
Hepatosplanchnic perfusion......Page 11
How should we use vasopressin?......Page 13
Summary......Page 14
References......Page 15
Epidemiology of acute heart failure......Page 18
Pathophysiologic considerations in acute heart failure......Page 19
Demographics, clinical presentation, and diagnostics......Page 20
Diagnostics......Page 21
Hemodynamic subsets......Page 22
Current pharmacologic strategies......Page 23
Diuretics......Page 24
Vasodilators (nitroglycerin, nitroprusside)......Page 26
Nesiritide......Page 27
Inotropes......Page 28
Vasopressin receptor antagonists......Page 29
Calcium sensitizers......Page 30
Pharmacoeconomic implications of acute heart failure......Page 31
Summary......Page 33
References......Page 34
Effect of Vasoactive Therapy on Cerebral Circulation......Page 39
Normal physiology......Page 40
Significance of hypertension in acute ischemic stroke......Page 42
Significance of hypertension in primary intracerebral hemorrhage......Page 44
Cardiovascular effect......Page 46
Cerebrovascular effect......Page 47
Cardiovascular effect......Page 48
Therapeutic implications......Page 49
Cerebrovascular effect......Page 50
Cardiovascular effect......Page 51
Therapeutic implications......Page 52
Cerebrovascular effect......Page 53
Fenoldopam......Page 55
Summary......Page 56
References......Page 57
Steroid physiology......Page 62
Adrenal insufficiency......Page 63
Laboratory diagnosis of adrenal insufficiency......Page 64
Adrenal insufficiency in critical illness......Page 65
Glucocorticoid replacement......Page 66
Outcome of steroid replacement......Page 67
References......Page 69
Absorption......Page 71
Perfusion abnormalities......Page 72
Motility dysfunction......Page 73
Distribution......Page 74
Fluid shifts......Page 75
Hepatic blood flow......Page 76
Intrinsic clearance......Page 77
Excretion......Page 79
Burn patients......Page 80
Medical and surgical patients......Page 81
Dosing and monitoring considerations......Page 82
Summary......Page 83
References......Page 84
Principles and Practices of Medication Safety in the ICU......Page 88
Prevalence......Page 90
The medication process......Page 94
Methods of medication error detection......Page 96
Analysis of errors for causes and outcomes......Page 97
Intensive surveillance programs......Page 98
Quality controls in the medication process......Page 99
Summary......Page 101
References......Page 102
Antimicrobial Resistance: Factors and Outcomes......Page 106
Antimicrobial resistance in intensive care units......Page 107
Impact of resistance in critically ill patients......Page 108
Selection of empiric drug therapy......Page 109
Application of pharmacokinetic and pharmacodynamic principles......Page 113
Broad-spectrum versus narrow-spectrum therapy and monotherapy versus combination therapy......Page 115
Duration of therapy......Page 116
Antibiotic formularies......Page 117
Guidelines and protocols for antimicrobial use......Page 118
Programs for restriction of target antibiotics and antibiotic cycling......Page 119
Antimicrobial management programs......Page 120
References......Page 121
Sedative and Analgesic Medications: Risk Factors for Delirium and Sleep Disturbances in the Critically Ill......Page 127
Prognostic significance of delirium......Page 128
Delirium: pathophysiology......Page 129
Sedatives and analgesic agents contributing to delirium......Page 130
Sleep deprivation in the critically ill......Page 135
Neurotransmission in sleep......Page 136
Summary......Page 137
References......Page 138
Drug-Associated Disease: Cytochrome P450 Interactions......Page 142
The cytochrome P450 isozymes......Page 144
Clinically significant drug interactions......Page 146
Drug interaction management......Page 153
Acknowledgments......Page 155
References......Page 156
Bone marrow underproduction cytopenias......Page 159
Myelodysplasia......Page 160
Drug-induced erythropoietin deficiency......Page 161
Drug-induced immune cytopenias......Page 162
Heparin-induced thrombocytopenia......Page 163
Drug-induced thrombotic thrombocytopenia purpura/hemolytic uremia syndrome......Page 164
References......Page 165
Obstructive nephropathy......Page 168
Results......Page 169
Discussion......Page 172
Nonsteroidal anti-inflammatory drugs......Page 174
Aminoglycosides......Page 175
Amphotericin B......Page 176
Radiocontrast dye......Page 177
beta-Lactam antibiotics (penicillins and cephalosporins)......Page 178
Acyclovir......Page 180
Tumor lysis syndrome......Page 181
References......Page 182
14.pdf......Page 186