Propofol, Ketamine, Dexmedetomidine — Oh My!

Patients in the ICU often require sedatives during mechanical ventilation or procedural sedation. With so many agents to choose from, it may be difficult to find the best drug to match each patient’s needs.

During “Pharmacology of Sedation in Critical Care: The Good, the Bad and the Ugly of Sedation Agents,” Monday, 1:45-2:45 p.m., in GRB, room 362, and Tuesday, 7:30-8:30 a.m., in GRB, room 372, Myron H. Arnaud and Matthew Lewis will break down the pharmacokinetics and pharmacodynamics of commonly used agents for sedation in critical care.

The speakers, both assistant professors of clinical nursing in the nurse anesthesia program at the University of Texas Health Science Center at Houston School of Nursing, will also present case study reviews to illustrate how sedation must be tailored to patients’ comorbidities and physiologic needs.

From morphine accumulation to propofol infusion syndrome, recognizing the attendant good, bad and ugly characteristics of each drug is key to sedation success, Arnaud says.

Attendees will also learn about over- and undersedation and how to avoid these scenarios.

“If you undersedate a patient, he or she will experience manifestations of physiologic stress,” Arnaud says. “Oversedation may cause inappropriate breathing, hemodynamic implications or difficulty waking up.”

“It’s important to understand what these agents do physiologically to the patient, how the patient metabolizes these drugs and what some of the short-term and long-term side effects are, especially in the critical care setting where patients might be subjected to sedative agents for extended periods of time,” Lewis says.