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 Table of Contents    
LETTER TO THE EDITOR
Year : 2023  |  Volume : 55  |  Issue : 5  |  Page : 340
 

Plasma drug concentration resulting from body surface area-based dosage


Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China

Date of Submission19-Jul-2023
Date of Decision20-Jul-2023
Date of Acceptance29-Aug-2023
Date of Web Publication02-Nov-2023

Correspondence Address:
Song Xue
Department of Cardiovascular Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijp.ijp_470_23

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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

How to cite this URL:
Wang H, Xue S. Plasma drug concentration resulting from body surface area-based dosage. Indian J Pharmacol [serial online] 2023 [cited 2023 Nov 28];55:340. Available from: https://www.ijp-online.com/text.asp?2023/55/5/340/389237




Dear Editor,

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].[1],[2] 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.[3]
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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mosteller RD. Simplified calculation of body-surface area. N Engl J Med 1987;317:1098.  Back to cited text no. 1
    
2.
Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery 1962;51:224-32.  Back to cited text no. 2
    
3.
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.  Back to cited text no. 3
    


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