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Medication Management to Ameliorate Post–Intensive Care Syndrome

Earnest Alexander, PharmD, and Gregory M. Susla, PharmD

AACN Advanced Critical Care

Medical Journal

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Critical Care Physicians, General Medical Professionals, Nurses and/or Other Critical Care Medical Professionals

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Mortality rates of critically ill patients have decreased markedly in recent years thanks to advancements in care. Given the improved survival rates of critically ill patients, investigators have broadened their focus from short-term mortality to long-term mortality and morbidities that are often under recognized by intensive care unit (ICU) practitioners. The Society of Critical Care Medicine (SCCM) has defined post–intensive care syndrome (PICS) as a new or worsening decrement in mental, cognitive, or physical health following critical illness that persists beyond the acute hospitalization. Many medication-related risk factors are associated with development of cognitive impairment in critically ill patients, including glucose dysregulation, delirium, and medications. Medications have also been associated with acute neuromuscular weakness following an ICU admission. In the past decade, the increased risk of adverse drug events (ADEs) during transitions of care has become widely known. This column focuses on how medication management strategies in the ICU, after the ICU, and after hospitalization may prevent or help manage PICS

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