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Recommended dosages...
Recommended dosages of analgesic and sedative drugs in intensive care result in a low incidence of potentially toxic blood concentrations
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- Lennborn, Ulrica (author)
- Uppsala universitet,Anestesiologi och intensivvård,Uppsala Univ, Sweden
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- Johansson, Anna (author)
- Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Linköping, Sweden.
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- Lindgren, Erik (author)
- Uppsala universitet,Anestesiologi och intensivvård,Uppsala Univ, Sweden
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- Nielsen, Elisabet I., 1973- (author)
- Uppsala universitet,Institutionen för farmaci,Uppsala Univ, Sweden
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- Sandler, Håkan (author)
- Uppsala universitet,Rättsmedicin,Uppsala Univ, Sweden
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- Bertilsson, Maria (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden
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- Kronstrand, Robert (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Linkoping, Sweden
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- Ahlner, Johan (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten
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- Kugelberg, Fredrik C. (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Linkoping, Sweden
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- Rubertsson, Sten (author)
- Uppsala universitet,Anestesiologi och intensivvård,Uppsala Univ, Sweden
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(creator_code:org_t)
- Upsala Medical Society, 2024
- 2024
- English.
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In: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 129
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Abstract
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- Background: Standard dosages of analgesic and sedative drugs are given to intensive care patients. The resulting range of blood concentrations and corresponding clinical responses need to be better examined. The purpose of this study was to describe daily dosages, measured blood concentrations, and clinical responses in critically ill patients. The purpose was also to contribute to establishing whole blood concentration reference values of the drugs investigated.Methods: A descriptive study of prospectively collected data from 302 admissions to a general intensive care unit (ICU) at a university hospital. Ten drugs (clonidine, fentanyl, morphine, dexmedetomidine, ketamine, ketobemidone, midazolam, paracetamol, propofol, and thiopental) were investigated, and daily dosages recorded. Blood samples were collected twice daily, and drug concentrations were measured. Clinical responses were registered using Richmond agitation-sedation scale (RASS) and Numeric rating scale (NRS).Results: Drug dosages were within recommended dose ranges. Blood concentrations for all 10 drugs showed a wide variation within the cohort, but only 3% were above therapeutic interval where clonidine (57 of 122) and midazolam (38 of 122) dominated. RASS and NRS were not correlated to drug concentrations.Conclusion: Using recommended dose intervals for analgesic and sedative drugs in the ICU setting combined with regular monitoring of clinical responses such as RASS and NRS leads to 97% of concentrations being below the upper limit in the therapeutic interval. This study contributes to whole blood drug concentration reference values regarding these 10 drugs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Keyword
- Analgesia
- sedation
- drug dosages
- drug concentrations
- intensive care medicine
- critical care
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Lennborn, Ulrica
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Johansson, Anna
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Lindgren, Erik
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Nielsen, Elisabe ...
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Sandler, Håkan
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Bertilsson, Mari ...
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Kronstrand, Robe ...
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Ahlner, Johan
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Kugelberg, Fredr ...
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Rubertsson, Sten
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Pharmacology and ...
- Articles in the publication
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Upsala Journal o ...
- By the university
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Uppsala University
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Linköping University