How does obesity affect drug dosing?
When lean body weight increases there will be a corresponding increase in drug clearance and an increased dose may be required. Commonly used weight-based drugs that may require dose adjustment and monitoring in obesity, and in particular morbid obesity, are listed in Table 2.
How is weight-based enoxaparin dosed in an obese patient?
In morbidly obese, medically-ill patients, use of weight-based enoxaparin dosed at 0.5 mg/kg once daily is feasible and results in peak anti-Xa levels within or near recommended range for thromboprophylaxis, without any evidence of excessive anti-Xa activity.
Is acyclovir dosing based on ideal body weight?
The manufacturer recommends calculation of intravenous (i.v.) acyclovir dose to be based on total body weight (TBW); however, in obese patients it recommends dosing by ideal body weight (IBW) (3).
Do obese people need more ibuprofen?
“There’s no data on ibuprofen in children that we can find, it’s a complete black hole,” Hawcutt says….Virtual humans.
| Panel: Examples of medicines where dosing is affected by weight | |
|---|---|
| Fluconazole | Vecuronium |
| Growth hormone | Voriconazole |
| Ibuprofen | Vortioxetine |
| Immunoglobulin |
How should anesthetics be dosed in obese patients?
In general, lean body weight is the most appropriate dose for most anesthetic drugs, with the exception of NDMB, where ideal body weight may be more appropriate. Succinylcholine should be dosed to total body weight.
How are the pharmacokinetics of a drug affected by obesity?
Pharmacokinetic changes in obese patients. Effect on absorption: Gastric emptying may be increased OR decreased (and it is unpredictable). Absorption from the subcutaneous compartment will be slowed due to poor blood flow to subcutaneous fat.
Is there a weight limit for Lovenox?
In clinical trials using enoxaparin for the treatment of DVT or PE, the 1 mg/kg Q 12 h dose was given to patients up to weights of approximately 150 kg. The maximum dose of enoxaparin should be 150 mg SC Q 12 h.
Is Lovenox dosed by actual body weight?
The LMWH agent enoxaparin (Lovenox) has no official dosing recommendations for these patients,3 but data in this population suggest that a reduced weight-based dose (less than 1 mg per kg) is warranted.
Why is acyclovir dosed on ideal weight?
Pharmacokinetic studies of intravenous (IV) acyclovir have demonstrated that dosing obese patients according to their ideal body weight (IBW) may provide a sub-therapeutic dose, while dosing based on total body weight (TBW) may increase adverse effects.
Why is adjusted body weight used for acyclovir dosing?
Dosing acyclovir on actual body weight (ABW) in obese patients may thus lead to supratherapeutic plasma concentrations because acyclovir distributes proportionally less in the excess fat tissue.
Do obese people need more medication?
NEW YORK (Reuters Health) – Obese adults in the United States use a number of prescription drug types more frequently than normal-weight adults, says a new study from researchers at the Centers for Disease Control and Prevention. Medications to treat high blood pressure and high cholesterol topped the list.
How many milligrams of cidofovir do you give for smallpox?
(Not approved by FDA) 5 mg/kg via IV infusion once. A second dose 1 week later may be considered if clinically indicated. Cidofovir is available under an IND protocol from the CDC as a second-line treatment of severe smallpox vaccine complications that have not responded to vaccinia immune globulin (VIG) treatment.
What are the precautions for infusion of cidofovir?
Consult WARNINGS section for additional precautions. -High-flux hemodialysis reduces serum levels of cidofovir by about 75%. -Prepare infusion by extracting the appropriate volume of drug from vial and transferring to an infusion bag containing 100 mL normal saline.
Is there a weight-based antimicrobial dosing guideline for morbidly obese patients?
A weight-based antimicrobial dosing guideline for morbidly obese patients was developed. An analysis of guideline compliance and cost analysis were performed following guideline implementation.
What is the role of hemodialysis in the treatment of cidofovir infection?
-High-flux hemodialysis reduces serum levels of cidofovir by about 75%. -Prepare infusion by extracting the appropriate volume of drug from vial and transferring to an infusion bag containing 100 mL normal saline. -Due to mutagenic properties, use of appropriate safety equipment for preparation, administration, and disposal is recommended.
