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February 17, 1989

The Pharmacologic Approach to the Critically III Patient

Author Affiliations

Wayne State University Detroit

Wayne State University Detroit

JAMA. 1989;261(7):1068. doi:10.1001/jama.1989.03420070118046

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This is an extremely important and informative book for anyone involved in the care of critically ill or injured patients. Its 900 + pages contain virtually everything a physician would like to know about any drugs that might be used in an intensive care unit (ICU).

Section I (183 pages) deals with pharmacokinetics, drug interactions, and the alterations in dosing and drug choices required with various types of organ failure. The chapters on pharmacokinetics and cardiovascular adreno-receptors are a bit complex, but then so is the subject.

Section II (118 pages), dealing with resuscitation pharmacology, reviews the agents used for cardiopulmonary resuscitation, drugs for central nervous system protection, colloids vs crystalloids, anesthetic agents, blood and blood components, red blood cell substitutes, and thrombolytic therapy. I thought that the "Crystalloid-Colloid" chapter was a bit skimpy, and it did not mention the current work on hypertonic saline. In the "Anesthetic" section, I would