Drug dosing and monitoring in obese patients undergoing allogenic stem cell transplantation

Langebrake, Claudia; Bernhardt, Friederike; Baehr, Michael; Zander, Axel R.

doi:10.1007/s11096-011-9568-0

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…Guidelines were recently published recommending use of actual weight and BSA for patients with abnormal BSA if the intent of therapy is cure . Clearance of drugs by glomerular filtration and metabolism by various cytochrome systems has been shown to differ in obese and non‐obese patients . However, little information is available on differences in pharmacokinetics between obese and non‐obese individuals for drugs used in this trial.…”

Section: Discussionmentioning

confidence: 99%

High-BMI at diagnosis is associated with inferior survival in patients with osteosarcoma: A report from the Children's Oncology Group

Altaf

Enders

Jeavons

et al. 2013

Pediatr Blood Cancer

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Section: Discussionmentioning

confidence: 99%

High-BMI at diagnosis is associated with inferior survival in patients with osteosarcoma: A report from the Children's Oncology Group

Altaf

Enders

Jeavons

et al. 2013

Pediatr Blood Cancer

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“…Langebrake et al [154], in providing recommendations for morbidly obese patients undergoing allogeneic haematopoietic stem cell transplantation, suggested that IBW be used due to the hydrophilic nature and high renal clearance of cotrimoxazole; however, this recommendation was not based on any patient data. Halilovic et al [111 & ] found morbidly obese patients with cellulitis AE cutaneous abscess given inappropriately low doses of cotrimoxazole or clindamycin on discharge had significantly higher rates of treatment failure; the authors suggested dosing of these antibiotics be based on patient's body mass (i.e.…”

Section: Cotrimoxazole Clindamycinmentioning

confidence: 99%

Dosing of antibiotics in obesity

Janson¹,

Thursky

2012

Current Opinion in Infectious Diseases

138

120

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Obesity causes a number of changes, including an increase in volume of distribution and changes in hepatic metabolism and renal excretion. Several antibiotics have sufficient data to be able to make recommendations, whereas other antibiotics may need to make use of doses at the upper end of the recommended range, or utilize other dose modifications based on pharmacokinetic/pharmacodynamic parameters, in an attempt to reach adequate levels and achieve similar efficacy.

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“…To meet the health needs and safe use of drugs by a patient with morbid obesity, specific material was also developed on the dose adjustment of the drugs most employed in HSCT according to actual weight, adjusted ideal weight or body surface. [29][30][31] Considering the frequent contacts of the other health professionals with the themes approached in the educational materials prior to their elaboration, we believe that they had a relevant impact in avoiding DRPs and qualifying the care offered. A systematic review published recently concluded that such materials can slightly improve the health practices.…”

Section: Discussionmentioning

confidence: 99%

Impact of the insertion of the clinical pharmacist in the Allogeneic Hematopoietic Stem Cells Transplantation team

Zanetti

Rodrigues

Varallo

et al. 2022

J Oncol Pharm Pract

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Introduction Allogeneic Hematopoietic Stem Cells Transplantation (allo-HSCT) is capable of curing patients with neoplastic or non-neoplastic hematologic disorders or of prolonging their survival. This study assessed if the insertion of the clinical pharmacist in the allo-HSCT team modified the outcomes: transplantation-related mortality, grafting failure, incidence of Graft versus Host Disease, hospitalization time, time for grafting, number of readmissions, number of drug-related problems (DRPs), adherence and knowledge about pharmacotherapy. Methods: Interventional study with historical control carried out in an allo-HSCT unit, in which the intervention group (IG) included 33 individuals who received pharmacotherapy follow-up. Control Group (CG) consisted of 28 individuals. Results: A total of 250 DRPs were identified, 59 team's doubts were clarified, and 309 interventions were conducted in the IG. The DRPs mainly arose from safety (51.60%) and effectiveness (38.40%) problems. A mean of 9.36 (SD = 6.97) interventions per patient was obtained, mainly including dose reductions (19.09%), adjustments in administration time (18.12%), educational activities (15.21%) and drug removal (10.68%). Clinical significance of the interventions was considered high (75.7% extremely significant, very significant or significant), as well as their acceptability (89.7% accepted). Each patient attended a mean of 4.68 pharmaceutical consultations (SD = 1.91) after hospital discharge, presenting increase in knowledge (p = 0.0001) and in adherence (p = 0.0115). There was no evidence of differences between the groups in the other outcomes analyzed. Conclusions: The pharmacotherapy follow-up allowed detecting several DRPs and performing interventions of high clinical relevance and acceptability, in addition to improving adherence and individualizing the pharmacotherapy.

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Drug dosing and monitoring in obese patients undergoing allogenic stem cell transplantation

Abstract: Pharmacotherapy in morbidly obese patients undergoing allogenic stem cell transplantation is possible, if pharmacokinetic properties of the drugs are considered and close monitoring of plasma concentrations is performed.

Cited by 10 publications

References 26 publications

High-BMI at diagnosis is associated with inferior survival in patients with osteosarcoma: A report from the Children's Oncology Group

High-BMI at diagnosis is associated with inferior survival in patients with osteosarcoma: A report from the Children's Oncology Group

Dosing of antibiotics in obesity

Impact of the insertion of the clinical pharmacist in the Allogeneic Hematopoietic Stem Cells Transplantation team

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