Breakpoints
#80 – Weighting on a Miracle: Understanding Unknowns of Dosing Children and Adults with Obesity
Jun 2, 2023
Dr. Amit Pai, a professor and chair of clinical pharmacy with expertise in pharmacokinetics, and Dr. Kate Kyler, an assistant professor of pediatrics focused on precision dosing in children, dive into the complexities of drug dosing for individuals with obesity. They discuss how obesity alters pharmacokinetics and the need for tailored dosing strategies, especially in pediatric populations. The conversation highlights the misconceptions around BMI and the pitfalls of traditional weight-based approaches, making a case for more effective therapeutic drug monitoring.
38:29
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Quick takeaways
- Obesity classification criteria significantly differ between adults and children, impacting accurate drug dosing and treatment efficacy.
- Physiological changes in obese patients alter drug pharmacokinetics and pharmacodynamics, necessitating careful dosing considerations to optimize therapeutic outcomes.
Deep dives
Understanding Obesity Classification
Obesity classification differs significantly between adults and pediatrics, primarily relying on body mass index (BMI) metrics. In adults, a BMI over 30 is categorized as obese, but this measure can misclassify individuals not genuinely in that category. For pediatric patients, obesity is defined as a BMI at or above the 95th percentile for their age and sex, with classifications into classes one, two, or three based on severity. Clinicians must be mindful of these distinctions to correctly assess dosing and treatment efficacy.
