Dr. Sherif Mahmoud, Maged Kharouba, Asma Aboelezz, Adham Elshamy and Ellen Gunn article published in Frontiers in Neurology

Congratulations to Dr. Sherif Mahmoud, Maged Kharouba, Asma Aboelezz, Adham Elshamy & Ellen Gunn for the publication of their recent paper in Frontiers in Neurology.

Title: Pharmacotherapy variability and precision medicine in neurocritical care

Authors: Sherif Hanafy Mahmoud, Maged Kharouba, Asma Aboelezz, Adham Elshamy, Ellen Gunn

Abstract: Pharmacotherapy variability is defined as the variability in drug response among

and within individuals that is attributed to the inter and intra-individual differences

in the action and disposition of drugs. Neurological and medical complications

in neurocritical care contribute significantly to the overall disease prognosis.

Pharmacological management plays a key role in managing many of those

complications such as cerebral vasospasm, delayed cerebral ischemia, hyponatremia,

infections, and seizures. However, pathophysiologic changes secondary to neurological

and critical illnesses make the medical management of these patients challenging,

contributing to pharmacotherapy variability. Interindividual differences in disease

pathophysiology, altered organ function, systemic inflammation, hemodynamic

instability, and common interventions employed in intensive care settings could alter

the pharmacokinetics and pharmacodynamics of medications. The use of potentially

ineffective treatments and suboptimal dosing of medications to manage patients

can lead to poor outcomes as the understanding of the effect of neurological injury

on the action and disposition of drugs is limited. This narrative review highlights the

factors contributing to pharmacotherapy variability in neurocritical care, equipping

clinicians with critical insights to refine patient management strategies. In conclusion,

pharmacotherapy variability within neurocritical care introduces additional layers

of complexity that may significantly contribute to therapy failure, adverse drug

reactions, and setbacks in drug development. Understanding these variations is

essential for identifying subpopulations that may derive the greatest benefit from

specific therapies, representing a critical step toward achieving precision medicine

in neurocritical care, ensuring the administration of the appropriate medication

to the right patient at the correct dosage regimen.

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