Synopsis of Important Principles Critical illnesses are often associated with circulatory, respiratory, hepatic and/or renal dysfunction that may alter the pharmacokinetics and/or pharmacodynamics of drugs. Decisions about routes of administration and doses of drugs used during medical emergencies must consider the physiological status of the patient, the pharmacokinetic and pharmacodynamic characteristics of the particular drug, [...]
Haemodialysis, peritoneal dialysis, haemoperfusion, exchange transfusion and forced diuresis have all been used in attempts to increase the rate of removal of drugs and poisons. However, the amount of active drug removed is often disappointingly small, and the indications for the use of such measures is very limited. Nevertheless, poisoned patients are often unnecessarily subjected [...]
The idea that drug concentrations could be measured and used to guide therapeutic decisions was first applied to quinidine when it was used to convert the cardiac rhythm of patients with atrial fibrillation to sinus rhythm (Sokolow & Ball 1956). Although quinidine is rarely used for this purpose today, because of the advent of DC [...]
Therapeutic drug monitoring is based upon the collaboration between a health care provider (clinician, pharmacist, nurse) responsible for making quantitative and qualitative decisions about drug treatment and the clinical laboratory providing analytical services for the measurement of drug concentrations. The information provided by a drug concentration measurement is generally greater than for other substances measured [...]
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