Psychopharmacology in the Critical Care Setting

2021 ◽  
pp. 235-250
Author(s):  
Sandeep Nayak ◽  
Jonathan Brigham ◽  
Ted Avi Gerstenblith ◽  
Elizabeth Prince
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Psychotropic Medications ◽  
Oral Medication ◽  
Critical Care Setting ◽  
Confounding Factors

Psychotropic medications can be a powerful tool for enabling treatment of critically ill patients. However, a careful approach to psychopharmacology is necessary in the critical care setting. Special considerations include interactions with other medications and treatments, high levels of physiologic stress that alter metabolism, and the challenges of obtaining diagnostic clarity due to limitations in assessment and confounding factors during critical illness. This chapter outlines common consult questions posed by intensive care teams to psychiatry consultation teams, including management of agitation and sedation, poor participation in care, anxiety, continuation of outpatient medication regimens, and alternatives to oral medication.

Anticonvulsants: Pharmacotberapeutic Issues in the Critically Ill Patient

1991 ◽  
Vol 2 (4) ◽  
pp. 639-656 ◽  
Author(s):  
Robert E. Dupuis ◽  
Jorge Miranda-Massari
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Epilepsy Treatment

Critically ill patients often have or develop conditions that make them susceptible to seizures and epilepsy. Treatment frequently involves the use of anticonvulsants. In order to use these effectively, the critical care nurse must be aware of the indications and controversies surrounding their use, the pathophysiologic conditions that impact on the disposition, and appropriate dosing and monitoring of these agents in the critical care setting

scholarly journals The effect of opioids on gastrointestinal function in the ICU

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Yun Yan ◽  
Yu Chen ◽  
Xijing Zhang
Keyword(s):  
Critical Care ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Potential Risk ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critical Care Setting ◽  
Gastrointestinal Function ◽  
Opioid Antagonists

AbstractGastrointestinal (GI) dysfunction is common in the critical care setting and is highly associated with clinical outcomes. Opioids increase the risk for GI dysfunction and are frequently prescribed to reduce pain in critically ill patients. However, the role of opioids in GI function remains uncertain in the ICU. This review aims to describe the effect of opioids on GI motility, their potential risk of increasing infection and the treatment of GI dysmotility with opioid antagonists in the ICU setting.

scholarly journals Sleep and Delirium in Pediatric Critical Illness: What Is the Relationship?

2018 ◽  
Vol 6 (4) ◽  
pp. 90 ◽  
Author(s):  
Amy Calandriello ◽  
Joanna Tylka ◽  
Pallavi Patwari
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Care Setting ◽  
Pediatric Intensive Care ◽  
Critical Care Setting ◽  
Pediatric Critical Care ◽  
Disturbed Sleep ◽  
Potential Risk Factors

With growing recognition of pediatric delirium in pediatric critical illness there has also been increased investigation into improving recognition and determining potential risk factors. Disturbed sleep has been assumed to be one of the key risk factors leading to delirium and is commonplace in the pediatric critical care setting as the nature of intensive care requires frequent and invasive monitoring and interventions. However, this relationship between sleep and delirium in pediatric critical illness has not been definitively established and may, instead, reflect significant overlap in risk factors and consequences of underlying neurologic dysfunction. We aim to review the existing tools for evaluation of sleep and delirium in the pediatric critical care setting and review findings from recent investigations with application of these measures in the pediatric intensive care unit.

scholarly journals Updates in Nutrition Support for Critically III Adult Patients

2017 ◽  
Vol 52 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Diana Wells Mulherin ◽  
Sarah V. Cogle
Keyword(s):  
Critical Care ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Hospital Pharmacist ◽  
Critical Care Medicine ◽  
Critical Care Setting ◽  
Nutrition Support ◽  
American Society

Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting.

Academic education. Creating a laboratory that simulates the critical care environment

1996 ◽  
Vol 16 (6) ◽  
pp. 76-81 ◽  
Author(s):  
PG Morton
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Teaching Method ◽  
Critical Care Setting ◽  
Academic Education ◽  
Clinical Experiences ◽  
Care Environment ◽  
Excellent Teaching

Educating students and practicing nurses for the complexities and demands of critical care is a challenge. Training in a laboratory that simulates the critical care setting is an excellent teaching method that can be used to supplement lectures and clinical experiences. Developing such a laboratory is an exciting and rewarding process that will promote learning and ultimately benefit the care of critically ill patients.

scholarly journals Electroencephalogram Monitoring in Critical Care

2020 ◽  
Vol 40 (06) ◽  
pp. 675-680
Author(s):  
Clio Rubinos ◽  
Ayham Alkhachroum ◽  
Caroline Der-Nigoghossian ◽  
Jan Claassen
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Unit ◽  
Care Setting ◽  
Eeg Monitoring ◽  
Electroencephalogram Eeg ◽  
Brain Monitoring

AbstractSeizures are common in critically ill patients. Electroencephalogram (EEG) is a tool that enables clinicians to provide continuous brain monitoring and to guide treatment decisions—brain telemetry. EEG monitoring has particular utility in the intensive care unit as most seizures in this setting are nonconvulsive. Despite the increased use of EEG monitoring in the critical care unit, it remains underutilized. In this review, we summarize the utility of EEG and different EEG modalities to monitor patients in the critical care setting.

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