Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Pharmaceutical, pharmacokinetic and pharmacodynamic drug-drug interactions (DDI) can complicate or facilitate anesthesia. Knowledge of the basic DDI mechanisms and DDI databases helps to avoid unwanted DDIs and to optimize wanted DDIs such as antidotes or desired synergism. ⋯ Inducers or inhibitors of cytochrome p450 3A4 can complicate postoperative therapy of raised blood pressure or pain (pharmacokinetic DDI). Pharmacodynamik DDIs like the impact of many drugs on blood pressure are the day-to-day armamentarium for anesthetists.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2014
Review[Preventive vaccinations for medical personnel].
Vaccinations are among the most efficient and important preventive medical procedures. Modern vaccines are well tolerated. In Germany there are no longer laws for mandatory vaccinations, either for the general public or for medical personnel. ⋯ Whereas vaccinations in childhood are generally considered to be a matter of course, the willingness to accept them decreases markedly with increasing age. In the medical sector vaccinations against, for example, hepatitis B are well accepted while other vaccinations against, for example, whooping cough or influenza are not considered to be so important. The fact that vaccinations, besides offering protection for the medical personnel, may also serve to protect the patients entrusted to medical care from nosocomial infections is often ignored.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2014
Review[Drug interactions in intensive care medicine].
Drug-drug interactions are a common problem in elderly multi-morbid patients receiving polypharmacy. A high quantity of prescribed drugs is associated with an increase in the risk of adverse effects and drug-drug interactions. More and more medical and pharmaceutical stakeholders are involved in the drug therapy of critically ill patients. ⋯ Pharmacokinetic drug interactions concern the influence of the cytochrome P450 enzymes and transport proteins in the body. Pharmacodynamic interactions can be found, for example, as an additive effect of drugs which are combined. The relevance of both aspects must accordingly be considered and negative impact should be avoided.