Final answer:
Hydrophilic drugs in obese patients are typically dosed based on lean body mass, as they primarily distribute in water compartments rather than fat tissue. The correct dosing of hydrophilic and lipophilic drugs depends on various factors, including the drug's distribution and the patient's body composition.
Step-by-step explanation:
The question asks how hydrophilic/lipophilic drugs should be dosed in obese patients. The correct approach to dosing medication in obese patients can be complex due to variations in how the drugs are distributed and metabolized in a body with a higher fat proportion. Factors such as hydrophilic or lipophilic characteristics of drugs, patient's total body weight, lean body mass, and ideal body weight, should all be considered when determining the correct dosage.
Hydrophilic drugs are more easily distributed in water tissue compartments than in fat, whereas lipophilic drugs tend to be more soluble in fat tissue. Generally, hydrophilic drugs should be dosed according to lean body mass (b), because they do not distribute well into fatty tissue, whereas lipophilic drugs might sometimes be dosed closer to total body weight due to their ability to distribute into fat. However, it's essential to note that dosing can also depend on how the drug is metabolized, particularly if the patient has liver or kidney dysfunction. It's always crucial to balance the therapeutic benefits against the risk of side effects, especially in obese patients.