Table 1.
Pharmacokinetic Studies in Obese Children
| Drug | N | Mean age, years (SD or range) |
Definition of obesity |
|---|---|---|---|
| Analgesics/anesthetics | |||
| Acetaminophen25 | 12 | 15 (2) | BMI ≥ 95%ile |
| Antipyrine26 | 3 | 17 (0) | BMI ≥ 95%ile |
| Propofol27 | 20 | 16 (2) | BMI ≥ 95%ile |
| Antibiotics | |||
| Cefazolin28 | 5 | 7 (3) | BMI ≥ 95%ile |
| Gentamicin29 | 25 | 10 (4) | BMI ≥ 95%ile |
| Tobramycin28 | 5 | 7 (3) | BMI ≥ 95%ile |
| Vancomycin17,18,30 | 112 | (0.2, 18) | BMI ≥ 85%17,18, ≥ 95%ile30 |
| Anticonvulsants | |||
| Carbamazepine31,19 | 9 | (15, 29) | BMI ≥ 95%ile31, BMI ≥ 25 (study mean 30)19 |
| Divalproex sodium20 | 5 | 9 (5, 14) | > 115% IBWa |
| Midazolam32 | - | - | BMI ≥ 95%ile |
| Valproic acid19 | 5 | 21 (15, 29) | BMI ≥ 25 (study mean 27) |
| Antineoplastics | |||
| Busulfan21 | 22 | 7 (6) | BMI ≥ 85%ile |
| Cytarabine33 | 10 | 9 (2, 18) | BMI ≥ 95%ile |
| Doxorubicin34,35 | 4 | (9, 16) | BMI ≥ 95%ile |
| Etoposide33,35 | 25 | 9 (2, 18) | BMI ≥ 95%ile |
| Mercaptopurine22 | 9 | 7 (4) | 75% W/H |
| Methotrexate33 | 41 | 9 (2, 18) | BMI ≥ 95%ile |
| Teniposide33 | 10 | 9 (2, 18) | BMI ≥ 95%ile |
| Immunosuppressants | |||
| Cyclosporine36 | 30 + 72 | 15 (4) | BMI ≥ 95% + BMI ≥ 85%ile |
| Respiratory stimulants | |||
| Caffeine37 | 3 | 17 (0) | BMI ≥ 95%ile |
| Theophylline23 | 9 | - | >125% IBW |
BMI %, age- and sex-specific BMI percentile (≥85th considered overweight, ≥95th considered obese)38; % IBW, percentile of ideal body weight (>120% considered overweight)39; BMI ≥ 25 (considered moderate obesity)40; % W/H, percentile of weight for height.38
a
For divalproex sodium, the authors did not stratify based on obesity, but found an empiric difference in PK for children less than and greater than 115% IBW.