ABSTRACT
In 2015, the directors of the Clinical Pharmacists Division of the Chilean Society of Intensive Care Medicine (SOCHIMI) organized a collaborative work along the country to define the minimum activities and duties that a pharmacist should perform in an Intensive Care Unit in Chile, according to the Ministry of Health and SOCHIMI guidelines and recommendations. This document summarizes the agreements on three priority areas of pharmacists' duties in intensive care: a) pharmacotherapy follow-up; b) pharmacological surveillance and security management of medications, and c) data recording and documentation. The recommendations collect the experiences from Chilean pharmacists along the country and provide information and support for future consensus for other specialties.
Subject(s)
Humans , Pharmacists , Pharmacy Service, Hospital/standards , Professional Role , Intensive Care Units , Pharmacy Service, Hospital/statistics & numerical data , Chile , ConsensusABSTRACT
Background: Critically ill patients in Intensive Care Units (ICUs) are exposed to multiple procedures and usually require complex treatment regimens. Many of them suffer from comorbidities and different complications such as organ failure, drug-drug interactions, and unusual therapeutic interventions that can produce significant pathophysiologic changes. For that reason, pharmacokinetics for several substances is different to what is described for healthy patients, complicating drug selection and drug dosage to achieve appropriate effects. Low doses may determine a reduction of drug effectiveness and overdoses leading to toxicity. The aim of this paper is to review the pharmacokinetic considerations that must be considered when treating acute ICU patients.
Subject(s)
Humans , Critical Illness , Intensive Care Units , Pharmacokinetics , Drug-Related Side Effects and Adverse ReactionsABSTRACT
La seguridad de los pacientes críticos en la Unidad de Cuidados Intensivos (UCI), ha sido progresivamente reconocida como un componente esencial de la práctica de la medicina intensiva moderna. La creación y promoción de equipos multidisciplinarios liderados por un intensivista ha demostrado mejorar la seguridad de la atención de salud. La incorporación de un farmacéutico con entrenamiento especializado a la UCI, ha generado un impacto positivo en los desenlaces clínicos y económicos. El fomento de la cultura de la seguridad en la UCI y el rediseño de los procesos defectuosos pueden mejorar significativamente la seguridad y calidad de la atención de los pacientes críticos.
The safety of critically ill patients in Intensive Care Unit (ICU) has been increasingly recognized as an essential component of the practice of modern intensive care. The creation and promotion of intensivist-led multidisciplinary teams has shown to improve the safety of health care. The addition in the ICU of a pharmacist with specialized training has generated a positive impact on clinical and economic outcomes. The promotion of safety culture in the ICU and the redesign of faulty processes can significantly improve the safety and quality of care of critically ill patients.