PHARMACOTHERAPY OF ANALGESIA, SEDATION AND NEUROMUSCULAR BLOCKADE IN CRITICALLY ILL PATIENTS WITH PULMONARY DISEASES

Authors

  • Pawanrat Svetsomboon Clinical Pharmacy Section, Pharmacy Division, Ramathibodi Hospital, Bangkok
  • Kanokrada Thammasri Clinical Pharmacy Section, Pharmacy Division, Ramathibodi Hospital, Bangkok
  • Vichapat Tharanon Clinical Pharmacy Section, Pharmacy Division, Ramathibodi Hospital, Bangkok
  • Tananchai Petnak Pulmonary and Critical Care Unit, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
  • Yuda Sutherasan Pulmonary and Critical Care Unit, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok

Keywords:

analgesia, sedation, neuromuscular blocking agents, critically ill patient, acute respiratory distress syndrome

Abstract

Critically ill patients with pulmonary disease who are admitted to the intensive care unit (ICU) generally experience procedural pain caused by life-saving treatment. Patients who receive ineffective pain treatment may frequently suffer from anxiety, agitation, or delirium. When the patients have already experienced these adverse conditions, the length of the mechanical ventilator and ICU stay might increase accordingly. Furthermore, patients with acute respiratory distress syndrome (ARDS) usually require deep sedation and a temporary paralysis state; therefore, analgesics, sedatives, and neuromuscular blocking agents are necessarily indicated in order to achieve the treatment. For critically ill patients to obtain the most effective and safe treatment with analgesics, sedatives, antipsychotics, and neuromuscular blocking agents administered, critical care pharmacists who provide pharmaceutical care to patients should have fundamental knowledge and be able to apply pragmatic pharmacotherapy, pharmacokinetics, and pharmacodynamics knowledge to optimize and personalize these medications for ARDS patients because they are high alert drugs with high adverse effects, aiming to provide patients with medicines that are effective, safe, and able to overcome crises.

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Published

2023-11-06

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Section

Review Articles