Psychopharmacology in the Critical Care Setting

S. Nayak, Jonathan Brigham, T. Gerstenblith, E. Prince
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Abstract

Psychotropic medications can be a powerful tool for enabling treatment of critically ill patients. However, a careful approach to psychopharmacology is necessary in the critical care setting. Special considerations include interactions with other medications and treatments, high levels of physiologic stress that alter metabolism, and the challenges of obtaining diagnostic clarity due to limitations in assessment and confounding factors during critical illness. This chapter outlines common consult questions posed by intensive care teams to psychiatry consultation teams, including management of agitation and sedation, poor participation in care, anxiety, continuation of outpatient medication regimens, and alternatives to oral medication.
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重症监护环境中的精神药理学
精神药物可以成为治疗危重病人的有力工具。然而,在重症监护环境中,谨慎的精神药理学方法是必要的。特别要考虑的因素包括与其他药物和治疗的相互作用,改变新陈代谢的高水平生理应激,以及由于评估的局限性和危重疾病期间的混淆因素而难以获得明确的诊断。本章概述了重症监护团队向精神病学咨询团队提出的常见咨询问题,包括躁动和镇静的管理,护理参与不良,焦虑,门诊药物治疗方案的延续,以及口服药物的替代方案。
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