Pharmacologic Considerations in Oncology Critical Care

Abstract

Critical care in the oncology population consists of diverse levels of diseases, syndromes, and emergencies that are not observed in typical medically-ill patients and, with it, comes even more specialized treatment strategies. Therefore, the uncommon or less well-understood pharmacologic considerations in this population must be discussed to better assist any clinician at the bedside. This chapter outlines some of the situations commonly encountered in this setting such as the challenge of treating and preventing infectious diseases when the patient lacks the ability to mount appropriate immune responses to conventional therapy, the paradigm of treating thromboembolism in the group of patients who are at highest risk for both bleeding and clotting and treatment of acute and long-term consequences of cancer or chemotherapy requiring escalation of care to the intensive care unit (ICU).

Vancomycin pharmacokinetic parameters in patients undergoing hematopoietic stem cell transplantation

“…9 Although a ratio of Area Under the Concentration Time Curve (AUC) to MIC of 400 or more has been suggested as the optimal target for therapeutic effects of vancomycin, a major part of infections in HSCT patients are of unknown etiologies and are treated empirically which makes this target relatively unreachable, therefore, an older and of debatable value target of attaining a trough concentration of vancomycin of 15 to 20 mg/L is usually applied in clinical practice in HSCT patients. 10,11…”