Bariatric Surgery and Medicine Dosages

[helvella]

There are so many reasons for people to need higher or lower doses of medicines. But I do wonder how many GPs (and they are predominantly the ones who actually prescribe) realise this issue?

Obes Surg. 2013 Feb 22. [Epub ahead of print]

Influence of Bariatric Surgery on the Use and Pharmacokinetics of Some Major Drug Classes.

Yska JP, van der Linde S, Tapper VV, Apers JA, Emous M, Totté ER, Wilffert B, van Roon EN.

Source

Department of Clinical Pharmacy and Clinical Pharmacology, Medisch Centrum Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, The Netherlands, [e-mail].

Abstract

The purpose of this review is to evaluate the influence of bariatric surgery on the use and pharmacokinetics of some frequently used drugs. A PubMed literature search was conducted. Literature was included on influence of bariatric surgery on pharmacoepidemiology and pharmacokinetics. Drug classes to be searched for were antidepressants, antidiabetics, statins, antihypertensive agents, corticosteroids, oral contraceptives, and thyroid drugs. A reduction in the use of medication by patients after bariatric surgery has been reported for various drug classes. Very few studies have been published on the influence of bariatric surgery on the pharmacokinetics of drugs. After bariatric surgery, theoretically, reduced drug absorption may occur. Correct dosing and choosing the right dosage form for drugs used by patients after bariatric surgery are necessary for optimal pharmacotherapy. Therefore, more clinical studies are needed on the influence of bariatric surgery on the pharmacokinetics of major drugs.

PMID: 23430479 [PubMed - as supplied by publisher]

ncbi.nlm.nih.gov/pubmed/234...

Rod

Picture: SAN DIEGO (May 11, 2011) Cmdr. Gordon Wisbach, director of Minimally Invasive and Bariatric Surgery at Naval Medical Center San Diego, prepares to insert an endoscope through a patient's belly button before performing a natural orifice endoscopic surgery (NOTES). NOTES is a surgical technique using an endoscope to perform abdominal operations through a body's natural orifice such as the nose or mouth. NMCSD is the first DoD military treatment facility to perform this type of surgery. (U.S. Navy photo by Mass Communication Specialist Seaman Clay Whaley/Released)

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[poing]

It would be better not to give people bariatric surgery... there's got to be a better solution to obesity than major surgery that leaves you unable to digest food.

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Poing, they can digest food.

They are talking about absorbing drugs. X

[poing in reply to Hidden]

Er, no they can't. Most of the stomach is removed or bypassed, and serious nutritional deficiency is very common afterwards, even in people that look after themselves.

[poing in reply to poing]

I should have expressed myself better, I'm not saying people can't digest food at all after bariatric surgery, but the amount of food people can eat afterwards is dramatically reduced (that's the point of the op) and their ability to digest and absorb nutrients is severely compromised too.

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That's right Poing, but you can still digest... You pooh just the same lol. You have to take extra vits of course as absorption is massively cut down.

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That's right Poing. We must have posted at same time. X

[PR4NOW]

Rod, I bet NBD could write quite an informed post about this subject. PR