Neuropharmacology in the ICU: Monitoring the Therapeutic Response and Neurological Hemodynamic Impact of Our Therapeutic Decisions in Real Time

Abstract

Vasoactive drugs impact both systemic and cerebral hemodynamic parameters. 2. Impaired cerebral autoregulation (CA) may cause an unwanted effect of a drug on central nervous system (CNS) vasculature. 3. Avoid abrupt hemodynamic changes that may lead to unwanted increases in intracranial pressure. 4. Optimization of mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) needs to be considered when selecting certain drugs due to their potential side effects. 5. Comorbid disease states, organ dysfunction, and temperature must be considered when administering medications that may alter cerebrovascular hemodynamics. 6. The use of noninvasive techniques, such as transcranial Doppler (TCD/TCCS), can serve as a tool for determining the therapeutic response of pharmacological treatments in neurocritical care patients.