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Related Concept Videos

Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

269
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...
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Obesity01:24

Obesity

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The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
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Dose Size and Dosing Frequency: Determination Methods01:21

Dose Size and Dosing Frequency: Determination Methods

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Determining the optimal dose size and dosing frequency in pharmacotherapy is crucial for achieving therapeutic effectiveness while minimizing adverse effects. This article explores the methodologies employed in determining these parameters, focusing on their significance and interplay to tailor dosing regimens.Dose Size: Dose size refers to the amount of a drug administered in a single dose. It is determined based on the drug's pharmacodynamics and pharmacokinetics properties and...
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Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

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A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
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Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Drug Dosing: Infants and Children01:29

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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...
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Multidisciplinary Approach to Obesity Management: A Case Report
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Argatroban dosing in obesity.

Stephanie Elagizi1, Kyle Davis1

  • 1Department of Pharmacy, Ochsner Medical Center, 1514 East Jefferson Hwy, New Orleans, LA 70121, United States.

Thrombosis Research
|January 26, 2018
PubMed
Summary

Obese patients do not require different argatroban doses than non-obese patients. This study found similar maintenance doses and outcomes, supporting weight-based dosing for argatroban regardless of BMI.

Keywords:
AnticoagulationArgatrobanHeparin induced thrombocytopeniaObesityVenous thromboembolism

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Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Obesity Research

Background:

  • Obesity alters drug pharmacokinetics and pharmacodynamics.
  • Weight-based anticoagulants like argatroban may pose risks for obese patients.

Purpose of the Study:

  • To evaluate argatroban dosing requirements in obese versus non-obese patients.
  • To assess if obesity influences argatroban maintenance dose needs.

Main Methods:

  • Retrospective cohort study of patients treated with argatroban.
  • Stratification into obese (BMI > 30 kg/m²) and non-obese (BMI ≤ 30 kg/m²) groups.
  • Primary outcome: median maintenance argatroban dose for therapeutic anticoagulation.

Main Results:

  • No clinically significant difference in median argatroban maintenance dose between obese and non-obese groups (1 μg/kg/min).
  • Obese patients had a median BMI of 35.8 kg/m² vs. 24.05 kg/m² in non-obese.
  • In-hospital bleeding and thrombosis rates were similar between groups.

Conclusions:

  • Obese patients require similar argatroban maintenance doses compared to non-obese patients.
  • Argatroban dosing should utilize actual body weight irrespective of patient BMI.