Oral drug therapy following bariatric surgery: an overview of fundamentals, literature and clinical recommendations

被引:76
作者
Azran, Carmil [1 ]
Wolk, Omri [2 ]
Zur, Moran [2 ]
Fine-Shamir, Noa [2 ]
Shaked, Gad [3 ]
Czeiger, David [3 ]
Sebbag, Gilbert [3 ]
Kister, Olga [4 ]
Langguth, Peter [4 ]
Dahan, Arik [2 ]
机构
[1] Herzliya Med Ctr, Clin Pharm, Herzliyya, Israel
[2] Ben Gurion Univ Negev, Sch Pharm, Dept Clin Pharmacol, Fac Hlth Sci, POB 653, IL-84105 Beer Sheva, Israel
[3] Soroka Univ, Dept Surg B, Med Ctr, Beer Sheva, Israel
[4] Johannes Gutenberg Univ Mainz, Inst Pharm Biopharmaceut & Pharmaceut Technol, Mainz, Germany
关键词
Bariatric surgery; bioavailability; drug solubility; intestinal permeability; GASTRIC BYPASS-SURGERY; MORBIDLY OBESE-PATIENTS; SYSTEMIC EXPOSURE; P-GLYCOPROTEIN; BILIOPANCREATIC DIVERSION; INTESTINAL PERMEABILITY; DEPENDENT PERMEABILITY; DUODENAL SWITCH; ABSORPTION; PHARMACOKINETICS;
D O I
10.1111/obr.12434
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bariatric surgery is the most effective solution for severe obesity and obesity with comorbidities, and the number of patients going through bariatric surgery is rapidly and constantly growing. The modified gastrointestinal anatomy of the patient may lead to significant pharmacokinetic alterations in the oral absorption of drugs after the surgery; however, because of insufficient available literature and inadequate awareness of the medical team, bariatric surgery patients may be discharged from the hospital with insufficient instructions regarding their medication therapy. In this article, we aim to present the various mechanisms by which bariatric surgery may influence oral drug absorption, to provide an overview of the currently available literature on the subject, and to draw guidelines for the recommendations bariatric surgery patients should be instructed before leaving the hospital. To date, and until more robust data are published, it is essential to follow and monitor patients closely for safety and efficacy of their medication therapies, both in the immediate and distant time post-surgery.
引用
收藏
页码:1050 / 1066
页数:17
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