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Related Concept Videos

Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...

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A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
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Vancomycin dosing in obese pediatric patients.

Brady S Moffett1, Shelly Kim, Morven S Edwards

  • 1Texas Children's Hospital, Houston, TX, USA.

Clinical Pediatrics
|February 2, 2011
PubMed
Summary

Obese children did not show increased vancomycin serum trough concentrations. Dosing for overweight children should use actual body weight, but further pediatric vancomycin metabolism studies are needed.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Clinical Pharmacy

Background:

  • Limited data exists for antimicrobial dosing in overweight pediatric populations.
  • The study investigated vancomycin serum trough concentrations in obese versus nonobese children.

Purpose of the Study:

  • To determine if obese children have altered vancomycin serum trough concentrations compared to nonobese children.
  • To guide antimicrobial dosing strategies for overweight pediatric patients.

Main Methods:

  • A retrospective, matched study design was used.
  • Vancomycin trough concentrations were compared between obese and nonobese children.

Main Results:

  • Obese children received 14.1 mg/kg of vancomycin, while nonobese children received 14.9 mg/kg (P = .03).

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  • A trend towards higher vancomycin serum concentrations was observed in obese children (6.9 μg/mL) versus nonobese children (4.8 μg/mL; P = .052).
  • Mean half-life and volume of distribution in obese patients were 2.9 hours and 0.35 L/kg, respectively.

    • Conclusions:

    • Obesity did not significantly alter vancomycin trough concentrations in children.
    • Vancomycin dosing for overweight children should be based on actual body weight.
    • Further research into vancomycin metabolism in pediatric populations is warranted due to lower-than-adult recommended troughs.