title: Consequences of gastrointestinal surgery on drug absorption.
abstract: Gastrointestinal (GI) surgery associated with resection or bypass can affect the absorption and kinetics of certain drugs. The goal of this article is 3-fold: (1) highlight the physiologic changes associated with selected GI surgeries (specifically gastric, small intestine, and colon), (2) review the implications for drug and nutrient absorption, and (3) suggest modifications of the pharmacologic agents, dosing regimens, and routes of delivery. Few large trials are available to use as references, but there is a wealth of individual reports and small series. Understanding the predictable challenges of drug administration in these patients will improve care.
authors.affiliation: Department of Surgery, Michigan State University, 221 Michigan NE, Ste 200A, Grand Rapids, MI 49503, USA. Rachel.Kuznar@grmep.com
authors.forename: Rachel
authors.initials: R
authors.lastname: Titus
authors.forename: Andrew
authors.initials: A
authors.lastname: Kastenmeier
authors.forename: Mary F
authors.initials: MF
authors.lastname: Otterson
mesh_terms: D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects; D041981:Gastrointestinal Tract / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism*; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D011183:Postoperative Complications
chemical_list: D004364:Pharmaceutical Preparations
keywords: bariatric surgery; digestive system surgical procedures; pharmacokinetics; short bowel syndrome