Ampicillin and Propylthiouracil Pharmacokinetics in Intestinal Bypass Patients Followed Up to a Year after Operation

Kampmann, Jens P.; Klein, H. C.; Lumholtz, Bo; Jm, Hansen

doi:10.2165/00003088-198409020-00004

Cited by 25 publications

(23 citation statements)

References 33 publications

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“…RYGBP was the predominant surgical procedure (n = 18) . In one study, BPD was investigated as the surgical procedure, while two studies investigated BPD‐DS, six studied SG, and one included jejunoileostomy …”

Section: Resultsmentioning

confidence: 99%

“…[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] In one study, BPD was investigated as the surgical procedure, 31 while two studies investigated BPD-DS, 41,50 six studied SG, [32][33][34]43,44,51 and one included jejunoileostomy. 52…”

Section: Interventionmentioning

confidence: 99%

“…Among the 22 studies, 16 utilized a single-dose design, [31][32][33][34][35][36][37]40,[42][43][44][45]47,48,52,53 administering a given dose of the studied drug on the day of the pharmacokinetic study intervention. In the remaining six studies, patients were investigated in steady state.…”

Section: Drugsmentioning

confidence: 99%

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The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review

et al. 2019

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Summary Anatomical changes in the gastrointestinal tract and subsequent weight loss may influence drug disposition and thus drug dosing following bariatric surgery. This review systematically examines the effects of bariatric surgery on drug pharmacokinetics, focusing especially on the mechanisms involved in restricting oral bioavailability. Studies with a longitudinal before‐after design investigating the pharmacokinetics of at least one drug were reviewed. The need for dose adjustment following bariatric surgery was examined, as well as the potential for extrapolation to other drugs subjected to coinciding pharmacokinetic mechanisms. A total of 22 original articles and 32 different drugs were assessed. The majority of available data is based on Roux‐en‐Y gastric bypass (RYGBP) (18 of 22 studies), and hence, the overall interpretation is more or less limited to RYGBP. In the case of the majority of studied drugs, an increased absorption rate was observed early after RYGBP. The effect on systemic exposure allows for a low degree of extrapolation, including between drugs subjected to the same major metabolic and transporter pathways. On the basis of current understanding, predicting the pharmacokinetic change for a specific drug following RYGBP is challenging. Close monitoring of each individual drug is therefore recommended in the early postsurgical phase. Future studies should focus on the long‐term effects of bariatric surgery on drug disposition, and they should also aim to disentangle the effects of the surgery itself and the subsequent weight loss.

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Section: Resultsmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 99%

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The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review

et al. 2019

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“…Similarly, Kampmann et al showed decreased absorption of ampicillin after an intestinal shunt procedure in six patients. [113] In addition, a case report suggested that the absorption of amoxicillin and macrodantin in a pregnant female who had undergone Roux-en-y gastric bypass was reduced. This patient was diagnosed with a urinary tract infection and, despite demonstrated bacterial sensitivity to these antibiotics, she did not improve after treatment.…”

Section: Drug Absorption and Bariatric Surgerymentioning

confidence: 99%

Vitamin, Mineral, and Drug Absorption Following Bariatric Surgery

Sawaya¹,

Jaffe²,

Friedenberg³

et al. 2012

CDM

111

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The prevalence of obesity continues to rise throughout the world. Increasingly, bariatric surgery is used for those with morbid obesity as a pivotal approach to achieve weight loss. Along with substantial weight loss, malabsorption of essential vitamins, minerals, and drugs also occurs. Therefore, more than ever, a better understanding of the physiology and mechanisms by which these deficiencies occur is essential. We review the normal physiology of vitamin, mineral, and drug absorption. This is followed by a description of currently performed bariatric surgeries in the United States. A detailed review of specific nutrient and mineral deficiency states is presented, based on the most significant studies published in the last two decades. Of note, screening and supplementation recommendations have been included. Drug absorption data after these procedures is presented and discussed. Studies were identified by searching the Cochrane Registry and MEDLINE using relevant search terms, as well as through review of the reference section of included manuscripts. Conclusions Bariatric surgery can be effectively used to achieve sustainable weight-loss in morbidly obese patients. It simultaneously brings forth important functional consequences on nutrient deficiencies and drug absorption that clinician’s must be aware of. Further prospective, randomized research on specific procedures and deficiencies is required.

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“…Generally unaltered except after intestinal bypass surgery Backman et al (1979) Benedech et al (1984) sorption of hydrochlorothiazide (Backman et al 1979) and ampicillin (Kampman et al 1984). In addition, the systemic availability of digoxin may be reduced (Marcus et al 1976).…”

Section: Absorption Distributionmentioning

confidence: 99%

Clinical Pharmacokinetics and Endocrine Disorders Therapeutic Implications

O’Connor

Feely

1987

Clinical Pharmacokinetics

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Endocrine disorders are common and produce widespread changes in cellular and organ function. Alterations in the sensitivity of patients with thyroid disorders to digoxin, anticoagulants and sedatives have been recognised for many years. Many of the recently documented kinetic alterations in endocrine patients are explicable on the basis of disease-induced changes in hepatic drug metabolism, protein binding and renal function. In hyperthyroidism the rate of absorption of paracetamol, propranolol and oxazepam is increased due to increased gastrointestinal motility. The volume of distribution of propranolol and digoxin is increased and there is decreased binding of both basic and acidic drugs as a consequence of alterations in alpha 1-acid glycoprotein and albumin concentration. The rate of glucuronidation of paracetamol and oxazepam is increased in hyperthyroidism. While oxidative metabolism of antipyrine, propranolol, metoprolol and theophylline is enhanced, the clearance of a number of other agents, including diazepam, warfarin, antithyroid drugs and phenytoin, is unaltered. The systemic clearance of propranolol is enhanced as a consequence of a 50% increase in liver blood flow. The rate of elimination of a number of endogenous substances, including cortisol, thyroid hormones and insulin, also appear to be enhanced. Hyperthyroidism has a variable effect on renal function, with a possible increase in digoxin elimination, but no effect on the clearance of renally excreted beta-blockers, atenolol, sotalol and nadolol. These kinetic changes suggest that individualization and higher than normal dosage of propranolol is necessary to control hyperthyroidism, and in thyrotoxic atrial fibrillation higher doses of digoxin or additional therapy with beta-blockers, or verapamil, may be indicated. The increased sensitivity of thyrotoxic patients to warfarin suggest care with dosage and frequent monitoring of response are warranted. Less information is available concerning hypothyroidism, but there is a general trend for decreased absorption of paracetamol and propranolol. In addition, the volume of distribution of digoxin is reduced, as is renal clearance. Limited studies suggest no alteration in the glucuronidation of oxazepam, but antipyrine clearance appears to be reduced. Steady-state propranolol concentrations are elevated in hypothyroidism and there appears to be a decreased metabolism of thyroid hormones and cortisol. Preliminary information suggests the binding of propranolol is increased. Thus, in the treatment of hypothyroid patients, a lower dosage of propranolol may be required.(ABSTRACT TRUNCATED AT 400 WORDS)

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Ampicillin and Propylthiouracil Pharmacokinetics in Intestinal Bypass Patients Followed Up to a Year after Operation

Cited by 25 publications

References 33 publications

The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review

The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review

Vitamin, Mineral, and Drug Absorption Following Bariatric Surgery

Clinical Pharmacokinetics and Endocrine Disorders Therapeutic Implications

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