The obese patient: Difference between revisions

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# Lean body mass '''(LBM)'''= Calc. based on subtracting body fat from TBW
# Lean body mass '''(LBM)'''= Calc. based on subtracting body fat from TBW


= Estimating Patient Weight =
= Estimating Patient Weight =
Multiple formulas to estimate weight, below are most common:
 
# '''Estimated male TBW''' = 93.2 + 3.29[arm circumference (cm)] + 0.43[height (cm)]
Multiple formulas to estimate weight, below are most common:  
# '''Estimated female TBW''' = 64.6 + 2.15[arm circumference (cm)] + 0.54[height (cm)]
 
# '''Estimated male IBW in kg''' = height in cm - 100
#'''Estimated male TBW''' = 93.2 + 3.29[arm circumference (cm)] + 0.43[height (cm)]  
## More accurate IBW estimate:
#'''Estimated female TBW''' = 64.6 + 2.15[arm circumference (cm)] + 0.54[height (cm)]  
### IBW (male) in kg = 50kg + 2.3kg for each in. over 5ft
#'''Estimated male IBW in kg''' = height in cm - 100  
# '''Estimated female IBW in kg''' = height in cm - 105
##More accurate IBW estimate:  
## More accurate IBW estimate:
###IBW (male) in kg = 50kg + 2.3kg for each in. over 5ft  
### IBW (female) in kg = 45kg + 2.3kg for each in. over 5ft
#'''Estimated female IBW in kg''' = height in cm - 105  
# '''Estimated LBM''' = 1.3 x IBW
##More accurate IBW estimate:  
# Others:
###IBW (female) in kg = 45kg + 2.3kg for each in. over 5ft  
## Epocrates has IBW calculator
#'''Estimated LBM''' = 1.3 x IBW  
##  
#Others:  
##Epocrates has IBW calculator  
##[Http://www.medcalc.com/body.html Medcalc]


= Medication Adjustments in Obesity =  
= Medication Adjustments in Obesity =  
Obesity alters hepatic/renal clearance and volume of distribution (Vd) of many drugs
Obesity alters hepatic/renal clearance and volume of distribution (Vd) of many drugs

Revision as of 05:24, 19 August 2013

Definitions

  1. Overweight = BMI 25-29
  2. Obesity = BMI 30-39
  3. Morbid obesity = BMI 40-49
  4. Super obesity = BMI >50
  1. Total body weight (TBW)= Actual weight
  2. Ideal body weight (IBW)= Calc. based on height & weight
  3. Lean body mass (LBM)= Calc. based on subtracting body fat from TBW

Estimating Patient Weight

Multiple formulas to estimate weight, below are most common:

  1. Estimated male TBW = 93.2 + 3.29[arm circumference (cm)] + 0.43[height (cm)]
  2. Estimated female TBW = 64.6 + 2.15[arm circumference (cm)] + 0.54[height (cm)]
  3. Estimated male IBW in kg = height in cm - 100
    1. More accurate IBW estimate:
      1. IBW (male) in kg = 50kg + 2.3kg for each in. over 5ft
  4. Estimated female IBW in kg = height in cm - 105
    1. More accurate IBW estimate:
      1. IBW (female) in kg = 45kg + 2.3kg for each in. over 5ft
  5. Estimated LBM = 1.3 x IBW
  6. Others:
    1. Epocrates has IBW calculator
    2. Medcalc

Medication Adjustments in Obesity

Obesity alters hepatic/renal clearance and volume of distribution (Vd) of many drugs

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