How should medicines be dosed in children who are obese?

  • Obesity results in physiological changes that can affect the volume of distribution and the clearance of drugs. The extent of these changes is variable and depends upon both patient –specific factors and the physico-chemical properties of the drug.
  • There are a lack of pharmacokinetic data on the use of commonly used drugs in obese children, therefore knowledge of which size descriptor to use in determining the optimum dose for this group of patients is limited.
  • Drug-dosing guidelines are typically derived from available data in obese adults.
  • Height measurements are needed on admission to hospital to identify obesity and to calculate doses based on the appropriate size descriptor.
  • Evidence-based, locally agreed guidance is required indicating which method to use for IBW calculation and which size descriptor to use for commonly used drugs in children to reduce variability and ensure optimal effectiveness and safety.
AciclovirAminophyllineBenzylpenicillinCarbamazepineClindamycinEnoxaparinEsomeprazoleGentamicinHeparinIbuprofenMetronidazoleMorphineOmeprazoleOndansetronPaediatric and neonatal medicineParacetamolPhenobarbitalPhenobarbital sodiumPhenoxymethylpenicillinPhenytoinPhenytoin sodiumPrednisoloneRanitidineTheophyllineTobramycinVancomycin

Attachments