The effects of altered PK/PD parameters on efficacy and toxicity of
therapeutic drugs in critically ill patients with COVID-19
Abstract
Although many therapies have been proposed, there is no evidence of any
effective treatment for COVID-19 to date. Currently, the main therapies
being used to treat the critically patients with COVID-19 are antiviral
drugs, chloroquine/hydroxychloroquine and respiratory therapy.
Pharmacokinetics (PK) and pharmacodynamics (PD) play an important role
in different clinical situations, and are keys to balance the effect
(reduction of SARS-CoV-2 virus and symptom improvement) and toxicity
(adverse effects). Critically ill patients always have altered PK and PD
due to multiple factors such as hypoproteinemia, organ dysfunction, and
organ support treatment including continuous renal replacement therapy
(CRRT), and extracorporeal membrane oxygenation (ECMO). Here we provide
an overview of the effects of the clinical treatments for critically
COVID-19 patients and the pathological state of patients on
pharmacokinetics and pharmacodynamics parameters of therapeutic drugs in
detail. However, current evidence is insufficient to speculate the
changes of drug concentration of antimicrobials, therapeutic drug
monitoring (TDM) is a useful tool used in severe patients since many
suspected factors were exist to influence the clinical responses and
adverse drug reactions of drugs.