Pharmacokinetic Changes Secondary to Roux en Y Gastric Bypass
|Christopher Giuliano1*, Sheila M. Wilhelm2 and Pramodini B. Kale-Pradhan1|
|1Eugene Applebaum College of Pharmacy and Health Science, Department of Pharmacy Practice, Wayne State University, St. John Hospital and Medical Center, Detroit, MI 48201, USA|
|2Eugene Applebaum College of Pharmacy and Health Science, Department of Pharmacy Practice, Wayne State University, Harper University Hospital, Detroit, MI 48201, USA|
|*Corresponding Author :||Christopher Giuliano
Pharm. D, Assistant Professor (Clinical)
Eugene Applebaum College of Pharmacy and Health Science
Department of Pharmacy Practice, Wayne State University
259 Mack Avenue, Detroit, MI 48201, USA
|Received September 21, 2012; Accepted October 17, 2012; Published October 19, 2012|
|Citation: Giuliano C, Wilhelm SM, Kale-Pradhan PB (2012) Pharmacokinetic Changes Secondary to Roux en Y Gastric Bypass. Adv Pharmacoepidem Drug Safety S1:001. doi:10.4172/2167-1052.S1-001|
|Copyright: © 2012 Giuliano C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objective: To review the influence of Roux-en-Y gastric bypass (RYGB) on pharmacokinetic parameters of medications.
Data sources: PubMed was searched from inception to September 2012 to identify studies. Search terms included bariatric surgery, gastric bypass, Roux-en-Y, pharmacokinetic, and absorption. Studies included for this review were limited to English language studies published in full.
Data synthesis: Obesity is a major health care concern and is on the rise. This has led to an increasing number of bariatric surgeries. Such procedures may have profound effects on pharmacokinetic parameters of many medications depending on the extent of surgical changes that are made. Surgical procedures such as RYGB are most likely to affect medication absorption. Factors that may affect medication absorption in RYGB patients include changes in intestinal or gastric pH, surface area, intestinal metabolism and transport mechanisms. Published studies have been primarily conducted in RYGB patients and have shown varied effect on overall absorption of medications.
Conclusions: RYGB may have profound effects on medication absorption. Predicting absorption is difficult due to interplay of several factors including, changes in intestinal surface area, intestinal metabolism, efflux pumps, active transporters and gastrointestinal pH. Future studies are needed, particularly studies evaluating medications that have a low bioavailability and are commonly used in the bariatric surgery population.