Neuropharmacology in the Intensive Care Unit

Crit Care Clin. 2023 Jan;39(1):171-213. doi: 10.1016/j.ccc.2022.07.007. Epub 2022 Oct 1.


Clinicians must individualize pharmacotherapy for patients with acute neurological injury based on multiple factors, including age, comorbidities, and chronic medication use. Many pharmacokinetic and pharmacodynamic properties are altered during acute illness, particularly absorption, distribution, metabolism, and elimination, which may result in loss of drug effect or toxicity. This article provides clinicians with general pharmacologic knowledge of the following drug regimens commonly prescribed to neurocritically ill adults: sedatives, analgesics, osmotherapy, antiseizure medications, antishivering agents, vasoactive agents, and antithrombotic reversal agents.

Keywords: Analgesia; Anticoagulants; Antiseizure drugs; Osmotherapy; Sedation; Vasopressors.

Publication types

  • Review

MeSH terms

  • Adult
  • Analgesics / pharmacology
  • Critical Care
  • Critical Illness
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Intensive Care Units*
  • Neuropharmacology*


  • Hypnotics and Sedatives
  • Analgesics