• Ann Pharmacother · Jul 2017

    Comparative Study

    Impact of Norepinephrine Weight-Based Dosing Compared With Non-Weight-Based Dosing in Achieving Time to Goal Mean Arterial Pressure in Obese Patients With Septic Shock.

    • Christopher A Droege and Neil E Ernst.
    • 1 UC Health - University of Cincinnati Medical Center Department of Pharmacy Services, Cincinnati, Ohio.
    • Ann Pharmacother. 2017 Jul 1; 51 (7): 614-616.

    AbstractObesity presents a growing challenge in critically ill patients because of variable medication pharmacokinetics and pharmacodynamics. Vasopressors used in the treatment of septic shock, including norepinephrine, are dosed using weight-based (WB) or non-weight-based (NWB) strategies. Retrospective research has evaluated the effect of total body weight and body mass index on vasopressor requirements, consequently finding that obese patients require less total vasopressor per kilogram to obtain clinical end points such as mean arterial pressure. Although this effect is not completely understood, this may suggest that a NWB dosing strategy is preferred over a WB strategy in obese patients to minimize potential for error.

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