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Drug dosing in obesity

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https://www.readbyqxmd.com/read/28220767/asthma-control-in-adult-patients-treated-with-a-combination-of-inhaled-corticosteroids-and-long-acting-beta-2-agonists-a-prospective-observational-study
#1
Barbara Rogala, Paweł Majak, Joanna Glück, Tomasz Dębowski
INTRODUCTION    Asthma is a highly prevalent disease that often requires maintenance therapy. Combined inhaled corticosteroid and long-acting beta-2 agonist (ICS/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 controlled asthma. PATIENTS AND METHODS    A total of 5789 asthma sufferers from Poland were enrolled in a prospective, observational study and treated with one of the following combined ICS/LABA inhalers at clinically appropriate doses: beclomethasone/formoterol, fluticasone/salmeterol, or budesonide/formoterol...
January 18, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28217249/cockcroft-gault-revisited-new-de-liver-ance-on-recommendations-for-use-in-cirrhosis
#2
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
#3
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
#4
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
#5
Raniah Q Gabr, Ahmed A El-Sherbeni, Mohamed Ben-Eltriki, Ayman Os 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 (iv). 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
#6
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
#7
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
#8
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
#9
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
#10
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)...
January 23, 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
#11
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
#12
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
#13
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
#14
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
BACKGROUND: Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic 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, piperacill-tazobactam, tobramycin, vancomycin, and voriconazole, are presented...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28065890/impact-of-obesity-on-antiretroviral-pharmacokinetics-and-immuno-virological-response-in-hiv-infected-patients-a-case-control-study
#15
Vincent Madelain, Minh P Le, Karen Champenois, Charlotte Charpentier, Roland Landman, Veronique Joly, Patrick Yeni, Diane Descamps, Yazdan Yazdanpanah, Gilles Peytavin
BACKGROUND: Obesity has high prevalence among HIV-infected patients. Increased adipose tissue mass affects the pharmacokinetics of numerous drugs, but few data are available for antiretroviral drugs. OBJECTIVES: In this study we aimed to explore the pharmacokinetics of antiretroviral drugs and the immuno-virological response in obese patients with HIV infection. PATIENTS AND METHODS: We examined data from 2009 to 2012 in our hospital's database for HIV-1-infected patients who received an antiretroviral drug (abacavir, emtricitabine, lamivudine, tenofovir, efavirenz, etravirine, nevirapine, atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir or raltegravir)...
January 8, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28065677/multistrategic-approach-to-improve-quality-of-care-of-people-with-diabetes-at-the-primary-care-level-study-design-and-baseline-data
#16
Mariana Prestes, María Angelica Gayarre, Jorge Federico Elgart, Lorena Gonzalez, Enzo Rucci, Juan José Gagliardino
AIM: To test the one year-post effect of an integrated diabetes care program that includes system changes, education, registry (clinical, metabolic and therapeutic indicators) and disease management (DIAPREM), implemented at primary care level, on care outcomes and costs. METHODS: We randomly selected 15 physicians and 15 nurses from primary care units of La Matanza County to be trained (Intervention-IG) and another 15 physicians/nurses to use as controls (Control-CG)...
January 5, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28056569/maternal-side-effects-fetal-neuroprotection-according-to-body-mass-index-after-magnesium-sulfate-in-a-multicenter-randomized-controlled-trial
#17
Gustavo Vilchez, Jing Dai, Moraima Lagos, Robert J Sokol
OBJECTIVE: Evidence supports the need of dose-adjustment of several drugs according to body mass index (BMI) to prevent toxicity in the underweight, and ensure efficacy in obese women. However, for MgSO4 neuroprotection, the effect of BMI on maternal toxicity and fetal neuroprotection is understudied. We analyze the effect of BMI on maternal/infant outcomes after MgSO4. METHODS: Secondary analysis of a clinical trial that studied MgSO4 neuroprotection. Maternal side effects, magnesium cord levels, and offspring cerebral palsy/death were analyzed along BMI strata using ANOVA and chi-square test...
January 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28054454/epoetin-beta-pegol-ameliorates-flow-mediated-dilation-with-improving-enos-coupling-state-in-non-obese-diabetic-rats
#18
Kenichi Serizawa, Kenji Yogo, Yoshihito Tashiro, Ryohei Kawasaki, Koichi Endo, Yasushi Shimonaka, Michinori Hirata
BACKGROUND/AIMS: Patients with diabetic nephropathy have a high cardiovascular mortality. Epoetin beta pegol (continuous erythropoietin receptor activator, C.E.R.A.) is a drug for the treatment of renal anemia. In this study, we investigated the effect of C.E.R.A. on vascular endothelial function as evaluated by flow-mediated dilation (FMD) and the relationship between hematopoiesis and FMD in diabetic nephropathy rats. METHODS: Male Spontaneously Diabetic Torii rats (SDT, 22 weeks old) were used...
January 5, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28028830/retrospective-evaluation-of-postoperative-adverse-drug-events-in-patients-receiving-rivaroxaban-after-major-orthopedic-surgery-compared-with-standard-therapy-in-a-community-hospital
#19
Nicole E Cieri, Kristen Kusmierski, Cynthia Lackie, August Van Opdorp, Amany K Hassan
STUDY OBJECTIVES: To evaluate the occurrence of bleeding and venous thromboembolic (VTE) events in patients receiving rivaroxaban, warfarin, or warfarin with the addition of enoxaparin during the immediate postoperative period following major orthopedic surgery. METHODS: Patients older than 18 years who received at least one dose of rivaroxaban the morning following surgery, adjusted dose warfarin, or adjusted dose warfarin with the addition of enoxaparin for VTE prophylaxis after major orthopedic surgery between October 1, 2011, and February 28, 2015, were included...
December 27, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28027534/asymptomatic-hyperuricemia-is-a-strong-risk-factor-for-resistant-hypertension-in-elderly-subjects-from-general-population
#20
Alberto Mazza, Salvatore Lenti, Laura Schiavon, Alvise Del Monte, Danyelle M Townsend, Emilio Ramazzina, Domenico Rubello, Edoardo Casiglia
OBJECTIVE: In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. MATERIAL AND METHODS: 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study...
February 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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