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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Drug Dosing: Obese Patients01:21

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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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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Implications for body weight extremes in solid organ transplantation.

Maya Campara1, Laura M Lourenco2, Jennifer I Melaragno3

  • 1Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, 60612, USA.

Pharmacotherapy
|December 10, 2020
PubMed
Summary

Understanding how body weight extremes affect drug levels is crucial for solid organ transplant patients. This review covers pharmacokinetic changes and dosing adjustments for immunosuppressants in these individuals.

Keywords:
BMIimmunotherapyobesitypharmacokineticstransplantunderweight

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Area of Science:

  • Pharmacology
  • Transplant Medicine
  • Clinical Pharmacy

Background:

  • Medication pharmacokinetics are altered in overweight and underweight individuals.
  • Limited data exist on pharmacokinetic differences in patients with extreme body mass index (BMI).
  • Solid organ transplant (SOT) programs are increasingly accepting patients with weight extremes.

Purpose of the Study:

  • To review pharmacokinetic and dosing considerations for extreme weight in SOT recipients.
  • To evaluate the impact of weight extremes on immunosuppression pharmacokinetics.
  • To inform clinical practice for managing SOT patients with varying BMI.

Main Methods:

  • Literature review of pharmacokinetic studies.
  • Analysis of dosing adjustments in SOT patients with extreme BMI.
  • Synthesis of information on weight management strategies and drug interactions.

Main Results:

  • Weight extremes significantly alter drug absorption, distribution, metabolism, and excretion.
  • Specific pharmacokinetic changes necessitate individualized immunosuppression dosing in SOT recipients.
  • Bariatric surgery and weight management products can further complicate drug pharmacokinetics.

Conclusions:

  • Optimizing immunosuppression in SOT patients with weight extremes requires careful pharmacokinetic evaluation.
  • Dosing strategies must account for BMI, weight changes, and potential drug interactions.
  • Further research is needed to refine management protocols for this growing patient population.