ABSTRACT
Anticipating and thus preventing adverse drug events (ADEs) is facilitated by an understanding of drug disposition and its changes in the critical patient. This chapter focuses on some of these changes, the role of drug interactions as the cause of an ADE, and methods by which clinicians might accommodate for these changes through modification of the dosing regimen. Changes in drug disposition in the critical care patient that may result in ADEs must consider species differences. The pharmacologic response to a drug reflects drug concentration at the tissue site, which in turn tends to be linearly related to plasma drug concentrations (PDCs). Peak and trough PDCs achieved following administration of a drug reflect the cumulative effect of several drug movements that determine drug disposition. A dosing regimen (comprised of a route, dose and interval) is designed to achieve and maintain targeted PDC throughout the dosing interval.
