JAMA Pediatr：肥胖儿童用药剂量怎么确定？

2015-05-15 MedSci MedSci原创

儿童肥胖的趋势已经稳定在一定的比例。在美国，几乎六分之一的儿童或青少年是肥胖的。这导致了身体组成和生理学的改变，这会影响到药物处置，可能导致治疗失败或者毒副作用。然而对于已有的与肥胖对药物安全、药物代谢动力学和肥胖儿童的用药剂量的深度探究仍是未知的。杜克大学的研究人员对此进行了一次系统性文献综述以描述当前掌握的儿童肥胖对于药物处置的影响的一些证据。研究人员检索了MEDLIN

儿童肥胖的趋势已经稳定在一定的比例。在美国，几乎六分之一的儿童或青少年是肥胖的。这导致了身体组成和生理学的改变，这会影响到药物处置，可能导致治疗失败或者毒副作用。然而对于已有的与肥胖对药物安全、药物代谢动力学和肥胖儿童的用药剂量的深度探究仍是未知的。杜克大学的研究人员对此进行了一次系统性文献综述以描述当前掌握的儿童肥胖对于药物处置的影响的一些证据。

研究人员检索了MEDLINE、Cochrane和EMBASE数据库（1970年1月1日-2012年12月31日）并且收录了包含药物清除率数据、分布容积或者18岁以下肥胖儿童的药物浓度的数据的研究。研究人员比较了肥胖和不肥胖儿童之间的暴露和体重标准化的分布容积和清除率。探索了药物的物理化学性质和清除率以及分布容积之间的联系。有二十项研究符合了筛选条件，包含了21种药物的药代动数据。每种药物的平均肥胖儿童数量为10人，年龄从新生儿到29岁（其中一项研究包括了儿童和成年人）。肥胖儿童的临床的药代动力学参数被观测到有显著改变。药代动力学参数改变导致了肥胖和非肥胖儿童之间暴露量的实质性差异。研究人员没有发现药物脂溶性和分布容积或清除率之间有由于肥胖导致的联系。

对于肥胖儿童来说，大多数合适的基于体重的剂量策略仍缺乏共识。为了确定治疗有效性并保证药物安全，对肥胖儿童进行前瞻性的药代动力学试验是有必要的。

原始出处：
Harskamp-van Ginkel MW, Hill KD, Becker K, et al. Drug Dosing and Pharmacokinetics in Children With Obesity: A Systematic Review.JAMA Pediatr. Published online May 11, 2015. doi:10.1001/jamapediatrics.2015.132.

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#插入话题

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2015-09-23 minlingfeng

#肥胖儿童#

47 0
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2016-02-22 feather89

#PE#

29 0
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2015-10-20 ms9608593228839890

#DIA#

24 0
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2015-05-17 huaxipanxing

看看

139 0
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2015-05-17 Dr.LV

确有必要

122 0
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2015-05-17 howi

#儿童用药#

18 0

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