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Drug dosing in obesity

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https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#1
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27913478/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#2
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27909874/is-daily-low-dose-aspirin-safe-to-take-following-laparoscopic-roux-en-y-gastric-bypass-for-obesity-surgery
#3
Xian Kang, Dennis Hong, Mehran Anvari, Maria Tiboni, Nalin Amin, Scott Gmora
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is a safe and effective procedure for patients with severe obesity. One potential complication of LRYGB is the development of marginal ulcers (MUs). Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to significantly increase the likelihood of developing marginal ulcers after surgery. However, the risk associated with low-dose aspirin consumption is not well defined. We examined the impact of daily low-dose aspirin (81 mg) on the development of marginal ulcers following LRYGB...
December 1, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27903151/how-to-manage-the-obese-patient-with-cancer
#4
Andrew G Renehan, Michelle Harvie, Ramsey I Cutress, Michael Leitzmann, Tobias Pischon, Sacha Howell, Anthony Howell
Purpose Obesity (body mass index [BMI] ≥ 30 kg/m(2)) is common among patients with cancer. We reviewed management issues in the obese patient with cancer, focusing on how obesity influences treatment selection (including chemotherapy dosing), affects chemotherapy toxicity and surgical complications, and might be a treatment effect modifier. Methods The majority of evidence is drawn from observational studies and secondary analyses of trial data, typically analyzed in N × 3 BMI categories (normal weight, overweight, and obese) matrix structures...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#5
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27895517/influence-of-curcumin-on-the-pharmacodynamics-and-pharmacokinetics-of-gliclazide-in-animal-models
#6
Leela Krishna Vatsavai, Eswar Kumar Kilari
PURPOSE: Patients suffering from obesity-related diseases use multiple prescription drugs to control their condition, and it is therefore essential to determine the safety and efficacy of any combination. Gliclazide is one of the most commonly used drug of choice for treatment of type 2 diabetes, and curcumin is a widely used herbal supplement to counter obesity condition. The objective of this study was to investigate the effect of oral administration of curcumin on pharmacodynamics and pharmacokinetics of gliclazide in rats and rabbits to further evaluate the safety and effectiveness of this combination...
2016: Journal of Experimental Pharmacology
https://www.readbyqxmd.com/read/27878474/quantitative-assessment-of-cyp2c9-genetic-polymorphisms-effect-on-the-oral-clearance-of-s-warfarin-in-healthy-subjects
#7
Chanan Shaul, Simcha Blotnick, Mordechai Muszkat, Meir Bialer, Yoseph Caraco
BACKGROUND: Genetic polymorphisms in CYP2C9 account for 10-20% of the variability in warfarin dose requirement. As such CYP2C9 genetic polymorphisms are commonly included in algorithms aimed to optimize warfarin therapy as a way to account for variability in warfarin responsiveness that is due to altered pharmacokinetics. However, most of the currently available pharmacokinetic data were derived from studies among patients on chronic warfarin therapy and therefore suffer from the confounding effects of disease states and drug interactions...
November 22, 2016: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/27871070/khat-catha-edulis-and-obesity-a-scoping-review-of-animal-and-human-studies
#8
Mustafa Ahmed Alshagga, Mohammed Abdullah Alshawsh, Atefehalsadat Seyedan, Abdulsamad Alsalahi, Yan Pan, Suresh Kumar Mohankumar, Abdolgodose Alkebsi, Saba Kassim, Zahurin Mohamed
BACKGROUND: Khat (Catha edulis) is a plant that is deeply rooted in the cultural life of East African and Southwestern Arabian populations. Prevalent traditional beliefs about khat are that the plant has an effect on appetite and body weight. SUMMARY: This review assesses the accumulated evidences on the mutual influence of monoamines, hormones and neuropeptides that are linked to obesity. A few anti-obesity drugs that exert their mechanisms of action through monoamines are briefly discussed to support the notion of monoamines being a critical target of drug discovery for new anti-obesity drugs...
November 22, 2016: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/27869362/fractal-geometry-based-decrease-in-trimethoprim-sulfamethoxazole-concentrations-in-overweight-and-obese-people
#9
R G Hall, J G Pasipanodya, C Meek, R D Leff, M Swancutt, T Gumbo
Trimethoprim-sulfamethoxazole (TMP-SMX) is one of the most widely drugs on earth. The World Health Organization recommends it as an essential basic drug for all healthcare systems. Dosing is inconsistently based on weight, assuming linear relationships. Given that obesity is now a global "pandemic" it is vital that we evaluate the effect of obesity on trimethoprim-sulfamethoxazole concentrations. We conducted a prospective clinical experiment based on optimized design strategies and artificial intelligence algorithms and found that weight and body mass index (BMI) had a profound effect on drug clearance and volume of distribution, and followed nonlinear fractal geometry-based relationships...
November 21, 2016: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/27869287/dexmedetomidine-for-attenuating-haemodynamic-response-to-intubation-stimuli-in-morbidly-obese-patients-anaesthetised-using-low-opioid-technique-comparison-with-fentanyl-based-general-anaesthesia
#10
Tomasz Gaszyński, Klaudia Czarnik, Łukasz Łaziński, Wojciech Gaszyński
BACKGROUND: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanyl-based or low-opioid using dexmedetomidine...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27866182/homeopathic-treatment-of-overweight-and-obesity-in-pregnant-women-with-mental-disorders-a-double-blind-controlled-clinical-trial
#11
Edgard Costa de Vilhena, Euclides Ayres de Castilho
Context • Worldwide, 35 million people suffer from obesity. Mental disorders have been associated with being overweight or obese. Considerable evidence has shown a correlation between stress and the use of homeopathy and stress and obesity. However, few studies have examined the relationship between weight loss and homeopathic treatment of obesity. Objective • The study intended to evaluate the efficacy of a homeopathic treatment in preventing excessive weight gain during pregnancy in overweight or obese women who were suspected of having a common mental disorder...
October 2016: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/27858284/role-of-cannabinoid-receptor-1-in-human-adipose-tissue-for-lipolysis-regulation-and-insulin-resistance
#12
Cherno O Sidibeh, Maria J Pereira, Joey Lau Börjesson, Prasad G Kamble, Stanko Skrtic, Petros Katsogiannos, Magnus Sundbom, Maria K Svensson, Jan W Eriksson
We recently showed that the peripheral cannabinoid receptor type 1 (CNR1) gene is upregulated by the synthetic glucocorticoid dexamethasone. CNR1 is highly expressed in the central nervous system and has been a drug target for the treatment of obesity. Here we explore the role of peripheral CNR1 in states of insulin resistance in human adipose tissue. Subcutaneous adipose tissue was obtained from well-controlled type 2 diabetes subjects and controls. Subcutaneous adipose tissue gene expression levels of CNR1 and endocannabinoid synthesizing and degrading enzymes were assessed...
November 17, 2016: Endocrine
https://www.readbyqxmd.com/read/27856470/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#13
REVIEW
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
November 17, 2016: Blood
https://www.readbyqxmd.com/read/27825800/dhl-hiszn-a-novel-antioxidant-enhances-adipogenic-differentiation-and-antioxidative-response-in-adipose-derived-stem-cells
#14
Chien-Chih Chen, Li-Wen Hsu, Toshiaki Nakano, Kuang-Tzu Huang, Kuang-Den Chen, Chia-Yun Lai, Shigeru Goto, Chao-Long Chen
Adipose-derived stem cells (ASCs) are multipotent progenitor cells that have the capacity to differentiate into specific mesenchymal cell lineages including adipocytes in response to environmental cues. Dysfunctional adipose tissue, rather than an excess of adipose tissue, has been proposed as a key factor in the pathogenesis of obesity-related diseases. The insulin-sensitizing effects of antidiabetic drugs are mediated by activation of peroxisome proliferator-activated receptor gamma (PPARγ). Here, we investigated the effects of sodium zinc histidine dithiooctanamide (DHL-HisZn), a strong antioxidant, on PPARγ activation, adipocyte differentiation and insulin sensitivity...
November 5, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27818118/-medical-induced-abortion
#15
K Bettahar, A Pinton, T Boisramé, V Cavillon, S Wylomanski, I Nisand, D Hassoun
OBJECTIVE: Updated clinical recommendations for medical induced abortion procedure. METHODS: A systematic review of French and English literature, reviewing the evidence relating to the provision of medical induced abortion was carried out on PubMed, Cochrane Library and international scientific societies recommendations. RESULTS: The effectiveness of medical abortion is higher than 95% when the protocols are adjusted to gestational age (EL1)...
November 3, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27812597/medication-and-nutritional-supplement-use-before-and-after-bariatric-surgery
#16
Charline Fernanda Backes, Edyane Lopes, Airton Tetelbom, Isabela Heineck
CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated...
October 31, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27798431/hemeoxygenase-1-as-a-novel-driver-in-ritonavir-induced-insulin-resistance-in-hiv-1-infected-patients
#17
Ninon Taylor, Iris Kremser, Simon Auer, Gregor Hoermann, Richard Greil, Elisabeth Haschke-Becher, Harald Esterbauer, Lukas Kenner, Hannes Oberkofler
BACKGROUND: Hemeoxygenase-1 (HO-1) has recently been identified as a major driver of metaflammation and obesity-related insulin resistance (IR). Drug-induced IR increases cardiovascular risk within the HIV-1-infected population receiving antiretroviral therapy (ART). We therefore investigated a possible role of HO-1 in ART-induced IR. METHODS: Effects of HIV-1 protease inhibitor ritonavir and integrase inhibitor raltegravir on expression levels of HO-1 and proinflammatory cytokines including interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNFα), Chemokine (C-C motif) ligand 5 (CCL5) and monocyte chemotactic protein 1 (MCP-1) were studied in monocyte and hepatocyte cell lines...
October 27, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27782940/effects-of-obesity-and-leptin-deficiency-on-morphine-pharmacokinetics-in-a-mouse-model
#18
Nicholas M Dalesio, Craig W Hendrix, Douglas Hale McMichael, Carol B Thompson, Carlton K K Lee, Huy Pho, Rafael S Arias, Rachael Rzasa Lynn, Jeffrey Galinkin, Myron Yaster, Robert H Brown, Alan R Schwartz
BACKGROUND: Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger, metabolism, and respiratory stimulation. We hypothesized that obesity and leptin deficiency impair opioid pharmacokinetics (PK) independently of one another. METHODS: Morphine PK were characterized in C57BL/6J wild-type (WT), diet-induced obese (DIO), and leptin-deficient (ob/ob) mice, and in ob/ob mice given leptin-replacement (LR) therapy...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27777205/-pharmacokinetics-of-a-cisatracurium-dose-according-to-fat-free-mass-for-anesthesia-induction-in-morbidly-obese-patients
#19
Jia-Yang Li, Qi-Rong Zou, Xue-Mei Peng
OBJECTIVE: To compare the pharmacokinetics of cisatracurium between normal weight patients and morbidly obese patients. METHODS: Twelve obese ASA I-II patients (BMI≥35 kg/m(2)) undergoing laparoscopic Roux-en-Y gastric bypass and 12 normal weight ASA I-II patients (BMI of 18.5-24 kg/m(2)) undergoing laparoscopic surgery were enrolled. The obese patients were given a cisatracurium dose of 0.15 mg/kg according to the fat-free mass (FFM), and the non-obese patients received a dose of 0...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27764050/a-pilot-study-of-randomized-head-to-head-of-metformin-versus-topiramate-in-obese-people-with-schizophrenia
#20
Po-Jui Peng, Pei-Shen Ho, Chia-Kuang Tsai, San-Yuan Huang, Chih-Sung Liang
OBJECTIVES: A number of research studies support the weight loss effects of metformin and topiramate for obese people with schizophrenia. However, only a few studies have addressed the sustainability of the body weight reduction after discontinuation of these drugs. Moreover, head-to-head studies are still lacking. The study aims to evaluate and compare the efficacy of metformin and topiramate in weight reduction and weight maintenance after discontinuation of these drugs in obese people with schizophrenia...
October 18, 2016: Clinical Neuropharmacology
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