Gaps in Drug Dosing for Obese Children: A Systematic Review of Commonly Prescribed Emergency Care Medications.

Clinical Therapeutics
Stevie RoweBest Pharmaceuticals for Children Act – Pediatric Trials Network Administrative Core Committee

Abstract

Approximately 1 of 6 children in the United States is obese. This has important implications for drug dosing and safety because pharmacokinetic (PK) changes are known to occur in obesity due to altered body composition and physiologic mechanisms. Inappropriate drug dosing in an emergency setting can limit therapeutic efficacy and increase drug-related toxic effects for obese children. Few systematic reviews examining PK properties and drug dosing in obese children have been performed. We identified 25 emergency care drugs from the Strategic National Stockpile and Acute Care Supportive Drugs List and performed a systematic review for each drug in 3 study populations: obese children (2-18 years of age), normal weight children, and obese adults (aged >18 years). For each study population, we first reviewed a drug's Food and Drug Administration label and then performed a systematic literature review. From the literature, we extracted drug PK data, biochemical properties, and dosing information. We then reviewed data in 3 age subpopulations (2-7 years, 8-12 years, and 13-18 years) for obese and normal weight children and by route of drug administration (intramuscular, intravenous, oral, and inhaled). If sufficient PK data were not a...Continue Reading

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Citations

Apr 24, 2016·Annals of Emergency Medicine·Kelly D Young, Noah C Korotzer
Aug 9, 2017·Clinical Pharmacokinetics·Anne van RongenCatherijne A J Knibbe
Sep 25, 2018·Journal of Clinical Pharmacology·Barbara Ameer, Michael A Weintraub
May 23, 2020·Obesity·Barbara Ameer, Michael A Weintraub
Aug 12, 2018·Paediatric Drugs·Valentina ShakhnovichUNKNOWN Best Pharmaceuticals for Children Act–Pediatric Trials Network
Oct 11, 2019·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Kai KangTsz-Yin So
Nov 4, 2020·Clinical and Translational Science·Thomas P GreenMichael Cohen-Wolkowiez

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