Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

[Drug dosing in extracorporeal therapy].

J T Kielstein1

  • 1Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland, kielstein@yahoo.com.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|May 22, 2014
PubMed
Summary

Dosing antibiotics in critically ill patients is complex due to altered pharmacokinetics and use of extracorporeal devices. This review highlights principles for optimizing anti-infective dosing and therapeutic drug monitoring in these challenging cases.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Melkersson-Rosenthal syndrome in the context of sarcoidosis: a case report.

Journal of medical case reports·2021
Same author

[Fomepizole, ethanol or dialysis in the case of life-threatening ethylenglycol intoxication?]

Medizinische Klinik, Intensivmedizin und Notfallmedizin·2020
Same author

Preoperative serum uric acid predicts incident acute kidney injury following cardiac surgery.

BMC nephrology·2018
Same author

[Prevention of acute kidney injury in critically ill patients : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI].

Medizinische Klinik, Intensivmedizin und Notfallmedizin·2018
Same author

[Extracorporeal renal replacement therapy in acute kidney injury : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI].

Medizinische Klinik, Intensivmedizin und Notfallmedizin·2018
Same author

[Dose adjustment of anti-infective drugs in patients with renal failure and renal replacement therapy in intensive care medicine : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI].

Medizinische Klinik, Intensivmedizin und Notfallmedizin·2018

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Nephrology

Background:

  • Drug dosing in critically ill patients is challenging due to altered pharmacokinetics (PK) and pharmacodynamics (PD).
  • Factors like fluid resuscitation, cardiac output, liver/renal failure, and extracorporeal devices significantly impact drug clearance.
  • Even in patients with normal renal function, PK/PD are altered, complicating antibiotic dosing.

Purpose of the Study:

  • To describe principles and knowledge for improving anti-infective agent dosing in critically ill patients.
  • To address challenges associated with extracorporeal treatments like extracorporeal membrane oxygenation and adsorber therapy.
  • To highlight the importance of therapeutic drug monitoring (TDM) for optimizing antibiotic therapy.

Main Methods:

Related Experiment Videos

  • Review of principles and basic knowledge for drug dosing in critically ill patients.
  • Discussion of resources such as drug dosing reference books and online tools (e.g., vancomycin dosing calculators).
  • Consideration of specific challenges posed by renal replacement therapy and extracorporeal devices.

    • Main Results:

    • Altered drug disposition and clearance necessitate careful consideration of patient-specific factors.
    • Lack of prompt readouts for antibiotic dosing, unlike other therapies, emphasizes the need for PK/PD guidance.
    • Extracorporeal treatments introduce unique challenges that must be addressed for safe and effective drug administration.

    Conclusions:

    • Therapeutic drug monitoring is crucial for optimizing antibiotic efficacy and safety in critically ill patients.
    • Global initiatives and regulatory guidance are needed to enhance pharmacokinetic studies in this population.
    • Integrating PK/PD knowledge into medical education is essential to address the unmet educational needs in critical care drug dosing.