Wait, Which Weight?: Weight-Based Dose Adjustments of Medications Commonly Used in the ED
Below is a table of common medications used in the emergency department that require dose adjustments based on the weight in the obese patient:
Important notes:
- ABW = actual body weight (kg)
- IBW = ideal body weight (kg)
- Calculation:
- Males: 50 + (2.3 x number of inches over height of 60″)
- Females: 45.5 + (2.3 x number of inches over height of 60″)
- Calculation:
- AdjBW = adjusted body weight (kg)
- To be used if ABW is at least 120% above IBW
- Calculation:
- IBW + 0.4 (ABW – IBW)
- *Phenytoin:
- Loading dose: AdjBW = IBW + 1.33 (ABW – IBW)
- Maximum loading dose: 2 g
- A large correction factor of 1.33 due to an expanded volume of distribution of phenytoin in the obese patient.
- Loading dose: AdjBW = IBW + 1.33 (ABW – IBW)
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