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Drug dosing in obesity

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https://www.readbyqxmd.com/read/28286500/diet-induced-obesity-does-not-alter-tigecycline-treatment-efficacy-in-murine-lyme-disease
#1
Helena Pětrošová, Azad Eshghi, Zoha Anjum, Nataliya Zlotnikov, Caroline E Cameron, Tara J Moriarty
Obese individuals more frequently suffer from infections, as a result of increased susceptibility to a number of bacterial pathogens. Furthermore, obesity can alter antibiotic treatment efficacy due to changes in drug pharmacokinetics which can result in under-dosing. However, studies on the treatment of bacterial infections in the context of obesity are scarce. To address this research gap, we assessed efficacy of antibiotic treatment in diet-induced obese mice infected with the Lyme disease pathogen, Borrelia burgdorferi...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28285294/the-conundrum-of-optimal-drug-dosing-in-obese-children
#2
Podhini Jegadeesan, Thirunavukkarasu Arun Babu
No abstract text is available yet for this article.
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28276790/new-onset-diabetes-mellitus-induced-by-statins-current-evidence
#3
Steven G Chrysant
The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with statins have shown that these drugs could induce new onset diabetes mellitus (NODM), especially in subjects prone to diabetes: obese, females, older age, Asian descent, and those with pre-diabetes or the metabolic syndrome...
February 24, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28257716/the-risks-and-benefits-of-long-term-use-of-proton-pump-inhibitors-expert-review-and-best-practice-advice-from-the-american-gastroenterological-association
#4
REVIEW
Daniel E Freedberg, Lawrence S Kim, Yu-Xiao Yang
BACKGROUND & AIMS: The purpose of this review is to evaluate the risks associated with long-term use of proton pump inhibitors (PPIs), focusing on long-term use of PPIs for three common indications: gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), and non-steroidal anti-inflammatory drug (NSAID) bleeding prophylaxis. METHODS: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed, EMbase, and the Cochrane library (through July 2016)...
March 2017: Gastroenterology
https://www.readbyqxmd.com/read/28240688/repeated-piperacillin-tazobactam-plasma-concentration-measurements-in-severely-obese-versus-nonobese-critically-ill-septic-patients-and-the-risk-of-under-and-overdosing
#5
Boris Jung, Martin Mahul, Dominique Breilh, Rachel Legeron, Jeremy Signe, Helene Jean-Pierre, Anne-Catrin Uhlemann, Nicolas Molinari, Samir Jaber
OBJECTIVE: Obesity and critical illness modify pharmacokinetics of antibiotics, but piperacillin-tazobactam continuous IV infusion pharmacokinetics has been poorly studied in obese critically ill patients. We aimed to compare pharmacokinetics of piperacillin in severely obese and nonobese patients with severe sepsis or septic shock. We hypothesized that plasma concentration variability would expose the critically ill to both piperacillin under and overdosing. METHODS: Prospective comparative study...
February 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28224315/modeling-of-free-fatty-acid-dynamics-insulin-and-nicotinic-acid-resistance-under-acute-and-chronic-treatments
#6
Robert Andersson, Tobias Kroon, Joachim Almquist, Mats Jirstrand, Nicholas D Oakes, Neil D Evans, Michael J Chappel, Johan Gabrielsson
Nicotinic acid (NiAc) is a potent inhibitor of adipose tissue lipolysis. Acute administration results in a rapid reduction of plasma free fatty acid (FFA) concentrations. Sustained NiAc exposure is associated with tolerance development (drug resistance) and complete adaptation (FFA returning to pretreatment levels). We conducted a meta-analysis on a rich pre-clinical data set of the NiAc-FFA interaction to establish the acute and chronic exposure-response relations from a macro perspective. The data were analyzed using a nonlinear mixed-effects framework...
February 21, 2017: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/28220767/asthma-control-in-adult-patients-treated-with-a-combination-of-inhaled-corticosteroids-and-long%C3%A2-acting-%C3%AE-2%C3%A2-agonists-a-prospective-observational-study
#7
Barbara Rogala, Paweł Majak, Joanna Glück, Tomasz Dębowski
INTRODUCTION    Asthma is a highly prevalent disease that often requires maintenance therapy. Combined inhaled corticosteroid (ICS) and long‑acting β2‑agonist (LABA) inhalers are one of the available maintenance treatment options. OBJECTIVES    This prospective observational study aimed to assess asthma control in patients treated with ICS/LABA inhalers and to identify factors related to optimal asthma control. PATIENTS AND METHODS    The study included 5789 asthmatic patients from Poland, treated with one of the following ICS/LABA inhalers at clinically appropriate doses: beclomethasone/formoterol, fluticasone/ salmeterol, or budesonide/formoterol...
January 18, 2017: Pol Arch Intern Med
https://www.readbyqxmd.com/read/28217249/cockcroft-gault-revisited-new-de-liver-ance-on-recommendations-for-use-in-cirrhosis
#8
REVIEW
Gianni B Scappaticci, Randolph E Regal
The Cockcroft-Gault (CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the limitations of the original serum creatinine (SCr) based equation, but also may not appreciate the validity of the many variations used to compensate for these limitations. For cirrhotic patients in particular, the underlying pathophysiology of the disease contributes to a falsely low SCr, thereby overestimating renal function with use of the CG equation in this population...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28209193/up601-a-standardized-botanical-composition-composed-of-morus-alba-yerba-mate-and-magnolia-officinalis-for-weight-loss
#9
Mesfin Yimam, Ping Jiao, Mei Hong, Lidia Brownell, Young-Chul Lee, Eu-Jin Hyun, Hyun-Jin Kim, Jeong-Bum Nam, Mi-Ran Kim, Qi Jia
BACKGROUND: The prevalence of obesity is surging in an alarming rate all over the world. Pharmaceutical drugs are considered potential adjunctive therapy to lifestyle modification. However, for most, besides being too expensive, their long term usages are hindered by their severe adverse effects. Here we describe the effect of UP601, a standardized blend of extracts from Morus alba, Yerba mate and Magnolia officinalis, in modulating a number of obesity-related phenotypic and biochemical markers in a high-fat high-fructose (HFF)-induced C57BL/6J mouse model of obesity...
February 16, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28185575/integration-of-metabolomics-lipidomics-and-clinical-data-using-a-machine-learning-method
#10
Animesh Acharjee, Zsuzsanna Ament, James A West, Elizabeth Stanley, Julian L Griffin
BACKGROUND: The recent pandemic of obesity and the metabolic syndrome (MetS) has led to the realisation that new drug targets are needed to either reduce obesity or the subsequent pathophysiological consequences associated with excess weight gain. Certain nuclear hormone receptors (NRs) play a pivotal role in lipid and carbohydrate metabolism and have been highlighted as potential treatments for obesity. This realisation started a search for NR agonists in order to understand and successfully treat MetS and associated conditions such as insulin resistance, dyslipidaemia, hypertension, hypertriglyceridemia, obesity and cardiovascular disease...
November 22, 2016: BMC Bioinformatics
https://www.readbyqxmd.com/read/28177686/pharmacokinetics-of-metformin-in-the-rat-assessment-of-the-effect-of-hyperlipidemia-and-evidence-for-its-metabolism-to-guanylurea
#11
Raniah Q Gabr, Ahmed A El-Sherbeni, Mohamed Ben-Eltriki, Ayman O El-Kadi, Dion R Brocks
Metformin pharmacokinetics are highly dependent upon organic cationic transporters. There is evidence of a change in its renal clearance in hyperlipidemic obese patients, and no information on its metabolic fate. To study some of these aspects, the influence of poloxamer 407 (P407)-induced hyperlipidemia on metformin pharmacokinetics was assessed. Control and P407-treated adult male rats were administered 30 mg/kg metformin intravenously (i.v.). The pharmacokinetic assessments were performed at 2 time points, 36 and 108 h, following the intraperitoneal dose of P407 (1 g/kg)...
December 15, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28168884/population-pharmacokinetics-and-pharmacodynamics-of-doripenem-in-obese-hospitalized-patients
#12
Eun Kyoung Chung, Megan R Fleming, S Christian Cheatham, Michael B Kays
BACKGROUND: Doripenem population pharmacokinetics and dosing recommendations are limited in obesity. OBJECTIVE: To evaluate the population pharmacokinetics and pharmacodynamics of doripenem in obese patients. METHODS: Hospitalized adults with a body mass index (BMI) ≥ 40 kg/m(2) or total body weight (TBW) ≥45.5 kg over their ideal body weight received doripenem 500 mg every 8 hours, infused over 1 hour. Population pharmacokinetic analyses were performed using NONMEM, and Monte Carlo simulations were performed for 5 intermittent and prolonged infusion dosing regimens to calculate probability of target attainment (PTA) at 40% and 100% fT>MIC (free drug concentrations above the minimum inhibitory concentration)...
March 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28143456/short-term-effectiveness-of-low-dose-liraglutide-in-combination-with-metformin-versus-high-dose-liraglutide-alone-in-treatment-of-obese-pcos-randomized-trial
#13
RANDOMIZED CONTROLLED TRIAL
Mojca Jensterle, Nika Aleksandra Kravos, Katja Goričar, Andrej Janez
BACKGROUND: Liraglutide 3 mg was recently approved as an anti-obesity drug. Metformin is weight neutral, yet it could enhance the therapeutic index of GLP-1 agonist. We compared weight-lowering potential of liraglutide 1.2 mg in combination with metformin to liraglutide 3 mg monotherapy in obese PCOS. METHODS: Thirty obese women with PCOS (aged 33.1 ± 6.1 years, BMI 38.3 ± 5.4 kg/m(2)) were randomized to combination (COMBO) of metformin (MET) 1000 mg BID and liraglutide 1...
January 31, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28126541/temporary-removal-pharmacokinetics-of-levonorgestrel-and-ulipristal-acetate-emergency-contraception-in-women-with-normal-and-obese-body-mass-index
#14
Piyapa Praditpan, Angie Hamouie, Cale N Basaraba, Renu Nandakumar, Serge Cremers, Anne R Davis, Carolyn L Westhoff
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
January 23, 2017: Contraception
https://www.readbyqxmd.com/read/28121368/pharmacokinetics-and-pharmacodynamics-of-single-doses-of-rivaroxaban-in-obese-patients-before-and-after-bariatric-surgery
#15
Dino Kröll, Guido Stirnimann, Andreas Vogt, Desirée Lin Lee Lai, Yves Michael Borbély, Julia Altmeier, Sabine Schädelin, Daniel Candinas, Lorenzo Alberio, Philipp C Nett
AIMS: Venous thromboembolism is an important cause of postoperative morbidity and mortality in bariatric surgery. Studies of direct oral anticoagulants (DOACs) are not available in this surgical field. The objective of this phase 1 clinical trial was to investigate pharmacokinetic and pharmacodynamic (PK/PD) parameters of rivaroxaban in bariatric patients. METHODS: In this single-centre study, obese patients received single oral doses of rivaroxaban (10 mg) one day before and three days after bariatric surgery...
January 25, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28118218/obesity-and-skin-and-soft-tissue-infections-how-to-optimize-antimicrobial-usage-for-prevention-and-treatment
#16
Mordechai Grupper, David P Nicolau
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are prevalent in the obese population, with rising trend expected. Although numerous antibiotics are available for the prevention and treatment of SSTIs, their characterization in obese patients is not a regulatory mandate. Consequently, information that carries importance for optimizing the dosing regimen in the obese population may not be readily available. This review focuses on the most recent pharmacokinetic and pharmacodynamic data on this topic with attention to cefazolin for surgical prophylaxis as well as antibiotics that are active against methicillin-resistant Staphylococcus aureus (MRSA)...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28116804/gabapentin-acutely-increases-the-apnea-hypopnea-index-in-older-men-data-from-a-randomized-double-blind-placebo-controlled-study
#17
Ronaldo D Piovezan, Camila Kase, Renato Moizinho, Sergio Tufik, Dalva Poyares
Although drugs with sedative properties may increase the risk of airway collapse during sleep, their acute effects on the apnea-hypopnea index in older adults are under-reported. We investigated the acute effects of gabapentin (GABA) on sleep breathing in older men without sleep apnea. A double-blind, randomized, placebo-controlled cross-over pilot study using a bedtime dose of gabapentin 300 mg was conducted in eight non-obese older men. Polysomnography measured the effects of the intervention. The apnea-hypopnea index was higher in the gabapentin arm than in the placebo arm (22...
January 24, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28114473/historical-perspective-on-the-rise-and-fall-and-rise-of-antibiotics-and-human-weight-gain
#18
Scott H Podolsky
In recent medical and popular literature, audiences have been asked to consider whether antibiotics have contributed to the rising obesity epidemic. Prominent magazines have stated that weight may be adversely affected by antibiotics that destroy existing microbiomes and replace them with less helpful ones. However, there is a long history of efforts to investigate the relationship between antibiotics and human weight gain. In the early 1950s, amid initial findings that low doses of antibiotics served as growth promoters in animal livestock, investigators explored the role of antibiotics as magic bullets for human malnutrition...
January 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28108679/therapeutic-drug-monitoring-and-use-of-an-adjusted-body-weight-strategy-for-high-dose-voriconazole-therapy
#19
Patrick G Richards, Kimberlyn M Dang, Carol A Kauffman, Kay Lyn Stalker, David Sudekum, Lisa Kerr, Michelle Brinker-Bodley, Beena Cheriyan, Nina West, Curtis D Collins, Shikha Polega, Anurag N Malani
OBJECTIVES: A high-dose 12 mg/kg/day (6 mg/kg twice daily) voriconazole regimen was recommended by the CDC to treat patients injected with contaminated methylprednisolone acetate that caused a multi-state fungal outbreak in 2012-13. Therapeutic drug monitoring results of this unique regimen are unknown, as is the most appropriate dosing weight for obese patients. We evaluated voriconazole trough measurements for this dosing scheme, as well as the use of adjusted body weight dosing for obese patients...
January 20, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#20
REVIEW
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs...
March 2017: Pharmacotherapy
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