Arzneimittelinteraktionen in der Intensivmedizin

Andreas Drust

doi:10.1055/a-0903-1767

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 2020; 55(05): 300-313
DOI: 10.1055/a-0903-1767

Topthema

CME-Fortbildung

Georg Thieme Verlag KG Stuttgart · New York

Arzneimittelinteraktionen in der Intensivmedizin

Drug-drug Interactions in Intensive Care

Andreas Drust

Abstract

Zusammenfassung

Arzneimittelinteraktionen sind auf Intensivstationen ein häufiges Problem. Dabei spielt die Gesamtmenge der verschriebenen Medikamente bei kritisch kranken Patienten eine große Rolle: Durchschnittlich werden hier 25 – 35 Medikamente pro Patient eingesetzt. Fundierte Kenntnisse über entsprechende pharmakodynamische und pharmakokinetische Mechanismen sind für die Behandlungssicherheit daher essenziell.

Abstract

Drug-drug interactions are common problems in intensive care units. Numerous studies could demonstrate the impact of the total amount of prescribed drugs and the occurrence of potential respectively manifest drug-drug interactions in critically ill patients. The average number of clinically used drugs in this setting is approximately 25 – 35 per patient, thus the profound knowledge of pharmacodynamic and pharmakokinetic mechanisms regarding drug interplay is important for treatment safety. This review aims to summarize the current evidence of drug interactions in intensive care patients. It especially features data regarding pharmacokinetics as main reason for clinically relevant drug-drug interactions. The most important drug classes noted in this context are analgesics and sedatives, antibiotics, antimycotics, antiepileptics, immune suppressive drugs, prokinetics and gastric acid regulating drugs. Furthermore, some pharmacodynamic interactions are described like QTc prolongation or serotonin syndrome. Additionally, a clinical case is demonstrated regarding the malignant impact of rifampin co-medication in a patient suffering from severe hypertension with the use of several antihypertensive drugs.

Schlüsselwörter

Arzneimittelinteraktionen - Intensivmedizin - Pharmakodynamik - Pharmakokinetik - klinische Pharmazie

Key words

drug-drug interactions - intensive care - pharmacodynamics - pharmacokinetics - clinical pharmacy

Full Text

References

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