Article Text

other Versions

PDF
Getting the dose right for obese children
  1. Brian J Anderson1,
  2. Nick HG Holford2
  1. 1Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
  2. 2Department of Pharmacology & Clinical Pharmacology, University of Auckland, Auckland, New Zealand
  1. Correspondence to Professor Brian J Anderson, Department of Anaesthesiology, University of Auckland, Auckland 1023, New Zealand; briana{at}adhb.govt.nz

Statistics from Altmetric.com

A survey conducted by Collier et al1 highlights the problem of drug dosing in obese children. The authors identify two aspects that require greater attention from paediatric practitioners: the identification of the obese child and the lack of use of ideal body weight (IBW) for drug calculation in that obese child. Both involve effort from prescribers to go beyond simply measuring total body weight (TBW). There remains a question about the benefits of using IBW compared with using TBW or any other measure of body mass. The lack of enthusiasm to calculate IBW obvious from the Collier et al survey is reflective of uncertainty concerning dose calculation in the obese child.

Collier et al propose anecdotally that using IBW rather than TBW would have avoided toxicity from an overdose of aminophylline. While we agree that aminophylline maintenance doses using TBW may be over-predicted in obesity, initial dosing based on either IBW or TBW for a target concentration (TC) of 10 mg/L is unlikely to be toxic.2 While the use of TBW to calculate initial doses may not be ideal for the maintenance dose, the problem could have been avoided by measuring …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Atoms
    R Mark Beattie