Name: OCTAVIO, PARILLA, PAYOT, RADA

Course/ Group No. BS-PHARMACY 3

Date:10-28-2022

LEARNING ACTIVITY NO. 3

BODY MASS INDEX DETERMINATION
OBJECTIVES
1. To compute for the body mass index of a person and know its category;
2. To determine how BMI affect a patient’s drug dosing regimen;
3. To appreciate the importance of maintaining one’s own healthy weight.

DISCUSSION:
Obesity can alter a drug’s pharmacokinetics, it is common in our society and it is an
imporant source of pharmacokinetic variation. With obesity, the ratio of body fat to lean
tissure is greater than in non-obese patients. Fat tissue contains less water than in lean
tissue is greater than in non-obese patients. Fat tissue containes less water than does
lean tissue, so the amoubt of body water per kilogram of total body weight is less in the
obese person than in the non-obese. For some drugs, alterations in body make up that
accompany obesity require changes in drug dosages.
Body Mass Index (BMI) is a number calculated from a person’s weight and height. BMI
provides a reliable indicator of body fatness for most people and is used to screen for
weight categories that may lead to health problems.
Calculating BMI is one of the best methods for population assessment of overweight
and obesity because calculation requires only height and weightm it is )BMI allows
people to compare their own weight status to that of the general population.
Other methods to measure body fatness include skinfold thickness measurements (with
calipers), underwater weighing, bioelectrical impedance, dual-energy x-ray
absorptiometry (DXA) and isotope dilution. However, these methods are not always
readily available, and they are either expensive or need highly trained personnel.
Furthermore, many of these methods can be difficult to standardize across observers or
machines, complicating comparisons across studies and time periods.
The formula for BMI measurement are as follows:
BMI= Weight (kg)
Height (m2)
BMI = Weight (lb) x 703
Height (in2)
Interpretation of BMI for Adults
For adults 20 years old and older, BMI is interpreted using standard weight status
categories that are the same for all ages for both men and women. For children and
teens, on the other hand, the interpretation of BMI is both age- and sex specific. The
standart weight status categories associated with BMI ranges for adults are shown in
the following table.
BMI WEIGHT STATUS
Below 18.5 Underweight
18.5-24.9 Normal
25.0- 29.9 Overweight
30.0 and above Obese

For and elderly person, a BMI of less than 21 can be sign of malnutrition. BMI in most
people is an indicator of high body fat (this may not be the case for persons who are
especially muscular). In addition to BMI, the NIH also considers waist circumference an
important factor in obesity - related disease. A waist circumference of more than 40
inches in men and more than 35 inches in women indicates an increased risk of
obesity-related diseases in persons who have a BMI of 25 to 35.
For example , here are the weight ranges, the corresponding BMI ranges, and the
weight status categories for a sample height.
Height Weight range BMI Weight status
124 lbs or less Below 18.5 underweight
5’9” 125 lbs to 168 lbs 18.5 to 24.9 Normal
169 lbs to 202 lbs 25.0 to 29.9 Overweight
203 lbs or more 30 or higher Obese
MATERIALS NEEDED
Weighing scale
Height measuring chart

PROCEDURE
1. The height and weight of at least 5 of the members of the family must be
obtained.
2. Body mass indexes must be computed and should be noted on the chart
provided.
3. The computations must be shown.
4. BMI must be interpreted as underweight, normal, overweight or obese.

DATA AND RESULTS:

Subject Height Weight BMI Interpretation
(in) (lb)
1. Rebecca ( 61.2 110.25 21 Normal
Mother)
2. Aaron (Father) 62.4 121.27 22 Normal
3. Jenny (Sister) 49.32 94.81 19 Normal
4. Gladen (Sister) 60 121.28 24 Normal
5. Bea (Me) 63.6 110.25 20 Normal

COMPUTATION:
Formula Use:
BMI = Weight (lb) x 703
Height (in2)
Rebecca Jenny Bea
110.25/ (61.22 ) X 703 94.81/ (49.322) X 703 110.25/(63.62)X 703
=21 =19 =20
Aaron Gladen
121.27/(62.42) X 703 121.28/ (602) X 703
= 22 = 24

QUESTIONS:
1. What are the other methods of measuring body fat? How does it differ from
BMI measurement?
Body Mass Index is a measure of body fat based on your height
and weight. Physicians widely consider BMI measurements as a simple
way to determine if a person is healthy or unhealthy, underweight or
overweight. However, there are other methods of measuring body fat.

Other methods of measuring body fat includes:

1. Skinfold thickness
This is probably the least appealing of all the methods, skinfold tests involve
pinching your body fat to determine how much of it sits on top of your muscle.
Skinfold thicknesses are more strongly associated with body fatness, as
estimated by various reference methods, than is BMI. These stronger
associations with body fatness, it is frequently assumed that skinfold thicknesses
would be better predictors of adverse health outcomes than BMI.
2. DEXA scan
DEXA stands for “Dual-Energy X-ray Absorptiometry,” because it uses the
absorption properties of your body to figure out which bits are fat and which are
muscles. It is incredibly more accurate than BMI, but too expensive and
inconvenient to be used widely.
3. Waist circumference and waist-to-hip ratio
 This is not technically a way of measuring overall body fat percentage,
since it only looks at your waist measurement, but it is an effective metric
for assessing health problems related to obesity. It gives an accurate
sense of health risk for various obesity-related problems in a way that BMI
just doesn’t.
4. Bioelectrical Impedance Analysis (BIA)
Bioelectrical impedance analysis (BIA) measures body composition based on the
rate at which an electrical current travels through the body. Body fat causes
greater resistance than lean mass and slows the rate at which the current travels.
Hence, the higher the resistance, the higher the body fat percentage calculation
is likely to be. Furthermore, it is said to be more accurate than BMI testing.

2. Is BMI an accurate indicator of determining body fat? Why or why not?

Since body fat is not accurately measured in calculating BMI (weight in

kilograms divided by height in meters squared), it is not a reliable measure of
body fat. In athletes with high bone density and muscle mass, BMI can increase
body fat while reducing it in elders with low bone density and muscle mass
because muscle and bone are thicker than fat. Therefore, direct measurements
of body fat demand the use of expensive and specialized equipment.

3. What are the health consequences of having a high BMI?

BMI is regarded as a substitute for determining whether a person is

overweight or obese, which increases their risk for developing diseases like
diabetes, high blood pressure, high cholesterol, heart disease, sleep apnea,
stroke, and some types of cancer.

4. Can you interpret the BMI for adults as the same for that of a child or teen?

Even though it is determined using the same formula as adult BMI, the
 BMI is applied differently to children and adults. The BMI of children and
teenagers must be gender- and age-specific because body fat percentage
changes with age and varies between boys and girls.

5. How can a low or high BMI affect the distribution of the following drugs; indicate if
the dosing should be increased or decreased. (Choose only 3 drugs available in an
article)

A. Thiopental OCTAVIO
High BMI or obesity influences the thiopental induction dose; the dose was
significantly less per kg in obese patients, because the initial volume of distribution is
similar between obese and lean patients, before redistribution occurs. Because of this
larger volume of distribution, the elimination half-life of thiopental is prolonged in obese
patients. In addition, the dose is usually proportional to body weight and obese patients
require a larger dose than relatively lean persons of the same weight.

B. Aminoglycosides PARILLA
The pharmacokinetics of aminoglycosides are altered by morbid obesity since both
Vd and clearance are higher in these patients than in people of normal weight. Loading
doses should be adjusted for Ideal Body Weight since the distribution of a medication
among adipose tissue and other tissues affects pharmacokinetics in obese patients
(IBW). Since medication distribution between fat and lean tissue affects
pharmacokinetics and aminoglycosides are hydrophilic drugs, aminoglycoside dosing in
obese critically ill patients is significantly more difficult. Aminoglycoside Vd in healthy
persons is around 0.26 L/kg (range: 0.2-0.3). However, because an estimated 40% of
the dose is transported into adipose tissue, aminoglycoside dosing in obese patients
requires modification using a correction factor of 0.4.
It's necessary to adjust drug dosage in obese patients, especially when utilizing
drugs with a limited therapeutic index. Obesity may need a variation from the dosages
typically advised for non-obese people due to changes in aminoglycoside
pharmacokinetic characteristics, but the impact of obesity on pharmacokinetics is not
well understood. Therapeutic failure or greater toxicity may occur from failing to alter
dosages in obese patients.

C. Phenylpropanolamine PAYOT
Phenylpropanolamine (PPA), an over-the-counter medication, is used to treat
obesity, though its efficacy is debatable. PPA increases weight loss in patients who are
on a hypocaloric diet and has no unfavorable side effects.

D. Amiodarone RADA
Amiodarone, one of the most commonly used AADs, is extremely lipophilic, with a
very large volume of distribution (60 L/kg) accumulating mainly in adipose tissue and
highly perfused organs. It has been shown that amiodarone clearance was significantly
reduced in those with a BMI >25, but there are no recommendations for dose
adjustments in obesity.

E. Atorvastatin
A high body mass index (BMI) is associated with increased cardiovascular risk. We
sought to identify whether BMI influences the choice of lipid‐lowering treatment in a
large, real‐world cohort of 52 916 patients treated with statins. The Dyslipidemia
International Study (DYSIS) is a cross‐sectional, observational, multicentre study in
statin‐treated patients ≥45 years of age from 30 countries; 1.1% were underweight
(BMI < 18.5 kg/m2), 33.1% had normal weight (BMI 18.5‐24.9 kg/m2), 41.5% were
overweight (BMI 25‐29.9 kg/m2), 17.1% had class I obesity (BMI 30.0‐34.9 kg/m2),
5.0% had class II obesity (BMI 35‐39.9 kg/m2), and 2.1% had class III obesity
(≥40 kg/m2).