ISSN: 2041-6792

Clinical Investigation

Pharmacodynamics Scientific Journals

 Pharmacotherapy of critically ill patients is challenging. Given the relative dearth of data available specifically for patients in ICUs, critical care pharmacists must use a combination of data extrapolation and clinical intuition to design optimal therapeutic dosing plans. Furthermore, each critically ill patient is distinct, with a differing pathogenesis and a rapidly changing physiology, which may further complicate treatment choices. The development of an individualized therapeutic plan requires the selection of a dosing and monitoring regimen that balances available information with the highest likelihood of positive outcome and minimal adverse effects. To successfully develop individualized dosing regimens and administer them to critically ill patients, an understanding of pharmacokinetics (PK), pharmacodynamics (PD), and pharmacogenomics (PGx) is paramount. Every drug entering the body follows an identical process of absorption, distribution, metabolism, and elimination—but one that is unique to that specific medication. That process ultimately determines how much drug is available at the targeted site of action. Pharmacokinetics refers to the sum of the processes the body is conducting on the drug. In contrast, pharmacodynamics refers to the physiologic and biochemical effects of the drug on the body. The intended effects of the drug, at a concentration that minimizes potential adverse effects, are determined by the intricate balance between PK and PD. Pharmacogenomics refers to a patient’s possible shift in the balance of PK and PD through innate genetic polymorphisms, which can alter the way the body and the drug (or its metabolites) interact with each other.

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