• Brian L Erstad.
• Department of Pharmacy Practice and Science, College of Pharmacy, Tucson, Arizona 85721-0207, USA. erstad@pharmacy.arizona.edu
• Intensive Care Med. 2004 Jan 1;30(1):18-32.

ObjectiveTo derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU.Data SourcesArticles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references.Study SelectionAll studies involving the pharmacokinetics or pharmacodynamics of medications in obese subjects or patients.Data ExtractionThe emphasis was on studies involving morbidly obese patients but, in the absence of such data, investigations involving lesser forms of obesity were extracted.Data SynthesisThere is a paucity of data upon which to make recommendations for dosing commonly used medications in the morbidly obese patient in the ICU, although recommendations were provided based on the available information.ConclusionsThere is clearly a need for more investigations involving dosing regimens of medications in the morbidly obese population. Until such studies are available, the clinician must try to derive the best dosing regimens for medications based on the limited pharmacokinetic data available for some agents and clinical judgement.

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