Optimising drug dosing in patients receiving extracorporeal membrane oxygenation

Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease a...

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Main Authors:	Cheng, Vesa, Abdul Aziz, Mohd. Hafiz, Roberts, Jason A., Shekar, Kiran
Format:	Article
Language:	English English English
Published:	AME Publishing Company 2018
Subjects:	RS192 Materia Medica-Pharmaceutical Technology
Online Access:	http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf

id	iium-64990
recordtype	eprints
spelling	iium-649902018-07-22T03:16:12Z http://irep.iium.edu.my/64990/ Optimising drug dosing in patients receiving extracorporeal membrane oxygenation Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran RS192 Materia Medica-Pharmaceutical Technology Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease and ECMO wean, minimisation of complications (treatment of complications when they do occur), early interruption of sedation and rehabilitation, maximising patient comfort and minimising risks of delirium. ECMO can alter both the pharmacokinetics (PK) and pharmacodynamics (PD) of administered drugs and our understanding of these alterations is still evolving. Based on available data it appears that modern ECMO circuitry probably has a less significant impact on PK when compared with critical illness itself. However, these findings need further confirmation in clinical population PK studies and such studies are underway. The altered PD associated with ECMO is less understood and more research is indicated. Until robust dosing guidelines become available, clinicians will have to rely on the principles of drug dosing in critically ill and known PK alterations induced by ECMO itself. This article summarises the PK alterations and makes preliminary recommendations on possible dosing approaches. ©Journal of Thoracic Disease. AME Publishing Company 2018-03-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf application/pdf en http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf Cheng, Vesa and Abdul Aziz, Mohd. Hafiz and Roberts, Jason A. and Shekar, Kiran (2018) Optimising drug dosing in patients receiving extracorporeal membrane oxygenation. Journal of Thoracic Disease, 10. S629-S641. ISSN 2072-1439 E-ISSN 2077-6624 http://jtd.amegroups.com/article/view/16468/13032 10.21037/jtd.2017.09.154
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	RS192 Materia Medica-Pharmaceutical Technology
spellingShingle	RS192 Materia Medica-Pharmaceutical Technology Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
description	Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease and ECMO wean, minimisation of complications (treatment of complications when they do occur), early interruption of sedation and rehabilitation, maximising patient comfort and minimising risks of delirium. ECMO can alter both the pharmacokinetics (PK) and pharmacodynamics (PD) of administered drugs and our understanding of these alterations is still evolving. Based on available data it appears that modern ECMO circuitry probably has a less significant impact on PK when compared with critical illness itself. However, these findings need further confirmation in clinical population PK studies and such studies are underway. The altered PD associated with ECMO is less understood and more research is indicated. Until robust dosing guidelines become available, clinicians will have to rely on the principles of drug dosing in critically ill and known PK alterations induced by ECMO itself. This article summarises the PK alterations and makes preliminary recommendations on possible dosing approaches. ©Journal of Thoracic Disease.
format	Article
author	Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran
author_facet	Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran
author_sort	Cheng, Vesa
title	Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
title_short	Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
title_full	Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
title_fullStr	Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
title_full_unstemmed	Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
title_sort	optimising drug dosing in patients receiving extracorporeal membrane oxygenation
publisher	AME Publishing Company
publishDate	2018
url	http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf
first_indexed	2023-09-18T21:32:12Z
last_indexed	2023-09-18T21:32:12Z
_version_	1777412585932455936

Optimising drug dosing in patients receiving extracorporeal membrane oxygenation

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