|LETTER TO THE EDITOR
|Year : 2023 | Volume
| Issue : 5 | Page : 340
Plasma drug concentration resulting from body surface area-based dosage
Heng Wang, Song Xue
Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
|Date of Submission||19-Jul-2023|
|Date of Decision||20-Jul-2023|
|Date of Acceptance||29-Aug-2023|
|Date of Web Publication||02-Nov-2023|
Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Wang H, Xue S. Plasma drug concentration resulting from body surface area-based dosage. Indian J Pharmacol 2023;55:340
The body surface area (BSA) constitutes a significant determinant for drug administration. Its relevance extends toward the aspects of effectiveness and toxicity, where the maximum concentration (Cmax) of drugs in plasma requires monitoring.
Employing Mosteller's and Nadler's formulas for the estimation of BSA and blood volume, respectively, a bolus injection might result in an irregular Cmax in the first compartment of pharmacokinetics [Figure 1]., Patients with smaller stature and lower body mass may experience a higher plasma drug concentration when administered with dosages based on BSA. Comparable results occur when utilizing alternate BSA computation methodologies, including those of Boyd, DuBois and DuBois, Gehan and George, and Haycock. In the case of oral dosage, the oral glucose tolerance test for diabetes diagnosis has shown a greater 2-h plasma glucose level in smaller individuals.
|Figure 1: Theoretical plasma drug concentration following bolus injection. The maximum concentration coefficient is determined by the ratio of the calculated body surface area to blood volume. This value can be multiplied by the ratio of dose (g·m − 2) to molar mass (g/mol). For this case, the quotient is one. In the context of continuous intravenous administration, correction should be made|
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Evidence-based guidelines still require further exploration to assess the toxicity of BSA-based dosage, considering the speed of administration and the area under the curve.
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| » References|| |
Mosteller RD. Simplified calculation of body-surface area. N Engl J Med 1987;317:1098.
Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery 1962;51:224-32.
Palmu S, Rehunen S, Kautiainen H, Eriksson JG, Korhonen PE. Body surface area and glucose tolerance – The smaller the person, the greater the 2-hour plasma glucose. Diabetes Res Clin Pract 2019;157:107877.