Pharmacokinetic considerations in the obese

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Anesthesiology

Background:

• Rising global obesity rates present significant clinical challenges.
• Obese patients are frequently excluded from drug development trials.
• Current drug dosing for obese individuals often relies on data from normal-weight subjects, potentially leading to suboptimal treatment.

Purpose of the Study:

• To provide a pragmatic approach to pharmacokinetic considerations for drug administration in obese patients.
• To systematically address dosing scalars and factors influencing pharmacokinetics in obesity.
• To discuss commonly used anesthetic agents in the context of obesity.

Main Methods:

• Systematic review of pharmacokinetic and pharmacodynamic variations in obesity.
• Analysis of factors affecting drug disposition in obese individuals.
• Focused discussion on anesthetic agents and their dosing in obese populations.

Main Results:

• Obesity induces numerous pharmacokinetic and pharmacodynamic variations with clinical implications.
• Dosing scalars and specific factors influencing drug behavior in obese patients are detailed.
• Commonly used anesthetic agents are analyzed for their altered pharmacokinetics in obesity.

Conclusions:

• Understanding obesity-induced pharmacokinetic changes is crucial for safe and effective drug administration.
• A systematic approach to dosing is necessary to optimize therapeutic outcomes in obese patients.
• This review provides essential guidance for clinicians managing obese patients, particularly in anesthesia and intensive care settings.