Pharmacology
Gabrielle Horstman, MD
Wake Forest Baptist Medical Center
Disclosure(s): No relevant financial relationship(s) to disclose.
Most critically ill patients can be adequately sedated, but some remain agitated and/or delirious despite optimal therapeutics at maximal doses. Although recent studies and meta-analyses have found no difference in outcomes between levels of sedation (light to deep), there is a known effect on outcomes in critically ill mechanically ventilated patients without any sedation. While the lightest sedation level should be targeted for most critically ill patients, deeper sedation is needed for some patients. Speakers will evaluate physiologic, pathophysiologic, and pharmacodynamic factors at the receptor level that influence patient response to sedatives, including preexisting comorbidities; patient-specific variables; and clinical course considerations that can alter pharmacology, receptor sensitization, and subsequent response or nonresponse. The properties of certain combinations of agents produce better outcomes than each agent alone. The roles of combinations with proven success, including ketamine and propofol, will be covered. Causes of agitation and delirium are often multifactorial in ICU patients. Traditional pharmacologic therapies may not address the driving influences of agitation or delirium. Alternative approaches, both pharmacologic and nonpharmacologic, and emerging strategies for achieving target sedation will be discussed.
Ahmed Reda Taha, MD (he/him/his) – Cleveland Clinic Abu Dhabi
Lisa D. Burry, PharmD, PhD, FCCM, FCCP (she/her/hers)
Charlotte A. Thomas, DNP, AGACNP-BC, CCRN – Scripps Mercy Hospital Chula Vista
