alexa Understanding the Impact of Critical Illness on Drug Pharmacokinetics - Scientifically Robust Study Design
ISSN: 2161-0495

Journal of Clinical Toxicology
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Review Article

Understanding the Impact of Critical Illness on Drug Pharmacokinetics - Scientifically Robust Study Design

Francia Van der Merwe1, Steven Wallis2, Andrew Udy1,2*

1Department of Intensive Care Medicine, Royal Brisbane and Womens Hospital, Herston, Queensland, Australia

2Burns, Trauma, and Critical Care Research Center, University of Queensland, Royal Brisbane and Womens Hospital, Herston, Queensland, Australia

*Corresponding Author:
Andrew A Udy
Staff Specialist, Department of Intensive Care Medicine
Royal Brisbane and Womens Hospital, and Senior Lecturer
Burns, Trauma and Critical Care Research Center
University of Queensland, Herston, Queensland, Australia
Tel: +61736368111
E-mail: [email protected]

Received date: October 31, 2011; Accepted date: January 19, 2012; Published date: January 22, 2012

Citation: der Merwe FV, Wallis S, Udy A (2012) Understanding the Impact of Critical Illness on Drug Pharmacokinetics - Scientifically Robust Study Design. J Clinic Toxicol S4:002. doi: 10.4172/2161-0495.S4-002

Copyright: © 2012 der Merwe FV, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Critical illness causes profound pathophysiological changes in almost all organ function, particularly the cardiovascular, respiratory, renal and hepato-billiary systems. These changes can alter the pharmacokinetic parameters of many commonly prescribed medications, such that sub-therapeutic or toxic drug levels are very real possibilities, particularly when employing standard drug dosing regimes. Furthermore, adequate drug exposure, especially when prescribing antimicrobial therapy, is often essential in minimizing morbidity and mortality in this setting. As such, some consideration of the unique characteristics of this patient population are essential when planning future pharmacological studies in this area.

The primary aim of this review is to examine the main pathophysiological changes seen in critical illness, particularly those encountered with sepsis, and explore the impact of these changes on drug pharmacokinetics. Secondarily, we also review some of the key methods available to investigate altered organ function and pharmacokinetics in this setting, with a focus on newer novel technologies.

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