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The study of mechanisms by which drugs can modify cellular and ultimately whole animal and human performance is still one of the most exciting branches of science. However and despite the fact that many physicians are frequently using some times more than 20 drugs simultaneously in critically ill patients, very few of them are able to understand the enormous complexity and variability of different therapeutic responses within patients and/or between patients suffering from critical illness.

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A majority of current pharmacokinetic and pharmacodynamic data are generated from studies in healthy volunteers and stable patients with single organ dysfunction. However, critically ill patients differ from other patients because of the complex and unstable nature of their illness. Critical illness results in multiple changes that alter drug disposition in the body. As organs fail, so the pharmacokinetic processes of absorption, distribution, and elimination are affected.

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