Seven subjects who underwent jejunoileal bypass surgery for massive obesity participated in a study to examine the relative bioavailability of digoxin before and one to two months after surgery. They were given a loading dose of 1 mg digoxin in divided oral doses followed by oral maintenance doses of 0.5 mg daily. There were no significant differences in the area under the serum concentration time curve, steady state serum levels or 24 hour steady state excretion of digoxin before and after surgery. We conclude that the bioavailability of digoxin from the Lanoxin tablets employed is not impaired in these patients, although urinary d-xylose and 24 hour fecal fat excretion indicated moderate to severe malabsorption after surgery.

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Methadone HCl is currently legally dispensed to approximately 80,000 heroin addicts in the United States. It is widely heralded as being virtually free from other than narcotic side effects. This report describes in detail three patients with massive fluid gain in a population of 420 addicts treated at the Hope Center methadone program in Tucson, Arizona. In no patient was there a prior history of edema, and an intensive search failed to reveal a cause for the swelling. Weight gain uniformly began 3 to 6 months after initiation of methadone or a sharp increase in the dosage, and in all three patients during periods when they sharply reduced or discontinued methadone, edema was resolved associated with a concomitant loss of weight.

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