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.
What antibiotics are weight-based?
Methods: A comprehensive literature search was performed on 15 weight-based antimicrobials in the setting of obesity: acyclovir, aminoglycosides, amphotericin B, cidofovir, colistimethate, daptomycin, flucytosine, foscarnet, ganciclovir, quinupristin/dalfopristin, trimethoprim/sulfamethoxazole, vancomycin and …
What happens when an obese person is given with a lipophilic drug?
With lipophilic drugs (e.g., barbiturates, benzodiazepines), this parameter is significantly increased, explaining the prolongation of the plasma elimination half-life. For drugs that are almost equally soluble in water and oil (methyl xanthines, aminoglycosides), the V is slightly increased in the obese.
What is a dosing weight?
Dosing Weight is an adjusted body weight (of obese or overweight patients) and should only be used to calculate the dose of drugs for which there are recommendations specifying that the actual body weight should be adjusted for use in the dose calculations.
Is there a weight limit for anesthesia?
Most operating tables are designed for patients of up to 120–140 kg in weight. For those who weigh more than this limit, specially designed tables may be needed. Position should be maintained to prevent nerve compressions and pressure sores.
How do you calculate medication by weight?
Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight….Example 2.
| Step 1. Calculate the dose in mg: | 18 kg × 100 mg/kg/day = 1800 mg/day |
|---|---|
| Step 3. Convert the mg dose to mL: | 1800 mg/dose ÷ 40 mg/mL = 45 mL once daily |
How many antimicrobials do obese people need to take?
We developed dosing recommendations for 34 antimicrobials based on 121 articles of the 2336 identified by the search strategy. Although 11 of these do not appear to require dose adjustment, obesity-specific dosing guidance is provided for the remaining 23 antimicrobials.
Which is the correct formula for aminoglycoside for obese patients?
Studies suggest that the initial dose of aminoglycoside for obese patients may be dosed based on ABW using this formula: ABW = IBW + 0.4 (TBW − IBW). TDM should be used to guide subsequent dose adjustments.
How does obesity affect the dosing of antibiotics?
Physiologic alterations seen in obesity commonly impact the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics and may result in suboptimal dosing in this expanding but understudied population.
Which is better for obese patients ceftaroline or cefepime?
Ceftaroline, ceftolozane-tazobactam, and ceftazidime-avibactam do not appear to require dose modifications in obesity, while cefepime and ceftazidime may. Second, heterogeneity in study designs was surprisingly common in the published literature.