title: Pharmacokinetics of drugs in cachectic patients: a systematic review.
abstract: Cachexia is a weight-loss process caused by an underlying chronic disease such as cancer, chronic heart failure, chronic obstructive pulmonary disease, or rheumatoid arthritis. It leads to changes in body structure and function that may influence the pharmacokinetics of drugs. Changes in gut function and decreased subcutaneous tissue may influence the absorption of orally and transdermally applied drugs. Altered body composition and plasma protein concentration may affect drug distribution. Changes in the expression and function of metabolic enzymes could influence the metabolism of drugs, and their renal excretion could be affected by possible reduction in kidney function. Because no general guidelines exist for drug dose adjustments in cachectic patients, we conducted a systematic search to identify articles that investigated the pharmacokinetics of drugs in cachectic patients.
authors.affiliation: Pharmacy Department, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: Katja
authors.initials: K
authors.lastname: Trobec
authors.forename: Mojca
authors.initials: M
authors.lastname: Kerec Kos
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
authors.forename: Jochen
authors.initials: J
authors.lastname: Springer
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
mesh_terms: D001823:Body Composition; D002100:Cachexia / Q000378:metabolism*; D054796:Drug Dosage Calculations; D006801:Humans; D010599:Pharmacokinetics; D014018:Tissue Distribution