Pharmacotherapy Pearls for Emergency Neurological Life Support

Neurocrit Care. 2017 Sep;27(Suppl 1):51-73. doi: 10.1007/s12028-017-0456-x.

Abstract

The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials. This article focuses on the important pharmacokinetic and pharmacodynamics characteristics, advantages and disadvantages and clinical pearls of these therapies, providing practitioners with essential drug information to optimize pharmacotherapy in acutely ill neurocritical care patients.

Keywords: Adverse drug event; Drug interaction; ENLS; Medication; Pharmacotherapy.

MeSH terms

  • Clinical Protocols* / standards
  • Critical Care / methods*
  • Critical Care / standards
  • Drug Therapy / methods*
  • Drug Therapy / standards
  • Emergency Medical Services / methods*
  • Emergency Medical Services / standards
  • Humans
  • Life Support Care / methods*
  • Life Support Care / standards
  • Nervous System Diseases / drug therapy*
  • Practice Guidelines as Topic*