ReviewClinical pharmacokinetics1998
Pharmacokinetics of drugs used in critically ill adults.
Review in Clinical pharmacokinetics, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 211 citations in OpenAlex.
- PK/PD modeling of a clazosentan thorough QT study with hysteresis in concentration-QT and RR-QT.Journal of pharmacokinetics and pharmacodynamics · 2021Trial
- Low Caspofungin Exposure in Patients in Intensive Care Units.Antimicrobial agents and chemotherapy · 2017Trial
- Pharmacokinetics and Bioavailability of a Fixed-Dose Combination of Ibuprofen and Paracetamol after Intravenous and Oral Administration.Clinical drug investigation · 2015Trial
- Pharmacokinetics of oral vs. intravenous dexamethasone in patients hospitalized with community-acquired pneumonia.British journal of clinical pharmacology · 2014Trial
- Safety, tolerability, and pharmacokinetics of intravenous oseltamivir: single- and multiple-dose phase I studies with healthy volunteers.Antimicrobial agents and chemotherapy · 2012Trial
- Pharmacokinetics of intravenous levofloxacin administered at 750 milligrams in obese adults.Antimicrobial agents and chemotherapy · 2011Trial
- Pharmacokinetics of moxifloxacin in patients with severe sepsis or septic shock.Intensive care medicine · 2010Trial
- Effect of time, injury, age and ethanol on interpatient variability in valproic acid pharmacokinetics after traumatic brain injury.Clinical pharmacokinetics · 2007Trial
- Antifactor Xa activity in critically ill patients receiving antithrombotic prophylaxis with standard dosages of certoparin: a prospective, clinical study.Critical care (London, England) · 2005Trial
- Pharmacokinetics and pharmacodynamics of imipenem during continuous renal replacement therapy in critically ill patients.Antimicrobial agents and chemotherapy · 2005Trial
- Pharmacokinetics of cefepime during continuous renal replacement therapy in critically ill patients.Antimicrobial agents and chemotherapy · 2001Trial
- Fentanyl Utilization During Extracorporeal Membrane Oxygenation and Risk of Methadone Treatment Among Pediatric ECMO Survivors.Pediatric surgery international · 2026Article
- Pharmacokinetics, safety, and tolerability of fedratinib in adults with moderate and severe hepatic impairment: results from the phase 1 FEDR-CP-001 trial.Cancer chemotherapy and pharmacology · 2025Article
- Population pharmacokinetics of intravenous fosfomycin: dose optimization for critically ill patients with and without kidney replacement therapy.Antimicrobial agents and chemotherapy · 2025Observational
- Bioavailability of Orally Administered Drugs in Critically Ill Patients.Journal of pharmacy practice · 2023Article
- Evidence-based rationale for low dose nivolumab in critically ill patients with sepsis-induced immunosuppression.Clinical and translational science · 2023Article
- Sustaining Life versus Altering Life-Saving Drugs: Insights to Explain the Paradoxical Effect of Extracorporeal Membrane Oxygenation on Drugs.Journal of clinical medicine · 2023Review
- Low and Highly Variable Exposure to Prophylactic LMWH Nadroparin in Critically Ill Patients: Back to the Drawing Board for Prophylactic Dosing?Clinical pharmacokinetics · 2023Article
- Pharmacokinetic Alterations Associated with Critical Illness.Clinical pharmacokinetics · 2023Review
- β-Lactam Dosing in Critical Patients: A Narrative Review of Optimal Efficacy and the Prevention of Resistance and Toxicity.Antibiotics (Basel, Switzerland) · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Critically ill patients exhibit a range of organ dysfunctions and often require treatment with a variety of drugs including sedatives, analgesics, neuromuscular blockers, antimicrobials, inotropes and gastric acid suppressants. Understanding how organ dysfunction can alter the pharmacokinetics of drugs is a vital aspect of therapy in this patient group. Many drugs will need to be given intravenously because of gastrointestinal failure. For those occasions on which the oral route is possible, bioavailability may be altered by hypomotility, changes in gastrointestinal pH and enteral feeding. Hepatic and renal dysfunction are the primary determinants of drug clearance, and hence of steady-state drug concentrations, and of efficacy and toxicity in the individual patient. Oxidative metabolism is the main clearance mechanism for many drugs and there is increasing recognition of the importance of decreased activity of the hepatic cytochrome P450 system in critically ill patients. Renal failure is equally important with both filtration and secretion clearance mechanisms being required for the removal of parent drugs and their active metabolites. Changes in the steady-state volume of distribution are often secondary to renal failure and may lower the effective drug concentrations in the body. Failure of the central nervous system, muscle, the endothelial system and endocrine system may also affect the pharmacokinetics of specific drugs. Time-dependency of alterations in pharmacokinetic parameters is well documented for some drugs. Understanding the underlying pathophysiology in the critically ill and applying pharmacokinetic principles in selection of drug and dose regimen is, therefore, crucial to optimising the pharmacodynamic response and outcome.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.