Tolerance and Withdrawal Issues with Sedatives in the Intensive Care Unit

Crit Care Nurs Clin North Am. 2016 Jun;28(2):155-67. doi: 10.1016/j.cnc.2016.02.010. Epub 2016 Mar 18.

Abstract

Prolonged use of sedative medications continues to be a concern for critical care practitioners, with potential adverse effects including tolerance and withdrawal. The amount of sedatives required in critically ill patients can be lessened and tolerance delayed with the use of pain and/or sedation scales to reach the desired effect. The current recommendation for prolonged sedation is to wean patients from the medications over several days to reduce the risk of drug withdrawal. It is important to identify patients at risk for iatrogenic withdrawal and create a treatment strategy.

Keywords: Iatrogenic withdrawal; Intensive care unit; Sedation; Tolerance.

Publication types

  • Review

MeSH terms

  • Critical Care Nursing
  • Critical Illness
  • Drug Monitoring / adverse effects
  • Drug Tolerance / physiology*
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Intensive Care Units*
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / drug therapy

Substances

  • Hypnotics and Sedatives