• Crit Care Nurs Clin North Am · Sep 2010

    Review

    Drug dosing considerations for the critically ill patient with liver disease.

    • Sonia Lin and Brian S Smith.
    • Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 41 Lower College Road, Fogarty Hall, Kingston, RI 02881, USA. SLin@uri.edu
    • Crit Care Nurs Clin North Am. 2010 Sep 1; 22 (3): 335-40.

    AbstractHepatic dysfunction in the critically ill patient presents a unique challenge to clinicians when designing pharmacotherapeutic treatment plans. Overall, the literature regarding drug dosing in critically ill patients with hepatic dysfunction is incomplete and current tools available to bedside clinicians have limitations. Despite these challenges, rational drug regimens can be implemented by critical care nurses who consider the potential impact of hepatic dysfunction on drug pharmacokinetics. This information can be applied clinically and careful monitoring plans can be implemented to assess a drug for efficacy and safety. This article reviews the pharmacokinetic changes that can occur in hepatic failure, identifies practical ways to quantify the severity of dysfunction, and discusses general drug dosing strategies in this patient population.(c) 2010 Elsevier Inc. All rights reserved.

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