Table 3.

Summary of changes in body composition with associated pharmacokinetic effects in obesity and malnutrition

Physiological variable	Change in obesity	Change in malnutrition	Pharmacokinetic consequence
Total body water	Increased	Increased	Increased VD for water-soluble drugs
Fat mass	Increased	Reduced	Increased dose in the obese to account for increased VD
LBW	Increased	Reduced	Increased clearance in obese patients
Plasma proteins	Increased	Reduced	Increased plasma protein binding in obese patients
Cardiac output	Increased	Reduced	Increased clearance in obese patients