减肥手术对药物药代动力学的影响:现有证据综述。

IF 4.6 3区 医学 Q1 NUTRITION & DIETETICS
Current Nutrition Reports Pub Date : 2023-12-01 Epub Date: 2023-10-20 DOI:10.1007/s13668-023-00498-5
Sofia K Konstantinidou, Georgia Argyrakopoulou, Maria Dalamaga, Alexander Kokkinos
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引用次数: 0

摘要

审查目的:肥胖是一个主要的公共卫生问题,已被公认为一种流行病。到目前为止,减肥手术仍然是严重肥胖患者长期减重的最有效方法。本综述的目的是总结最常见的减肥手术类型,即Roux-en-Y胃旁路术(RYGB)和袖状胃切除术(SG)如何影响药物的药代动力学。最近的研究结果:关于减肥手术后药物药代动力学变化的数据有限。现有指南的缺乏可能导致患者出现药物毒性或治疗不足。术后需要考虑的药代动力学参数包括胃动力、胃容量、pH、表面积、胆汁分泌物、载体蛋白和首过代谢。对于治疗指数较窄的药物,需要密切监测其他因素,包括血浆药物水平、患者的临床结果和实验室标志物。应经常对患者进行随访,并根据其对药物治疗的反应进行治疗。减肥手术可能会影响各种药物的药代动力学,因为由此产生的解剖变化和体重的大幅减轻。因此,有必要识别这些潜在的变化并调整患者的药物剂量,以获得更高的疗效并避免毒性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Bariatric Surgery on Pharmacokinetics of Drugs: a Review of Current Evidence.

Purpose of review: Obesity constitutes a major public health concern and has been recognized as an epidemic. To date, bariatric surgery remains the most effective way for substantial long-lasting weight loss in severe obesity. The purpose of this review is to summarize how the pharmacokinetics of drugs are affected by the most common types of bariatric surgery, i.e., Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Recent findings: Limited data are available regarding the changes in pharmacokinetics of drugs after bariatric surgery. The lack of existing guidelines may lead patients to experience drug toxicity or therapeutic undertreatment. Pharmacokinetic parameters that need to be taken into consideration postoperatively include gastric motility, gastric volume, pH, surface area, bile secretions, carrier proteins, and first-pass metabolism. For drugs with a narrow therapeutic index, other factors need to be monitored closely, including plasma drug levels, patients' clinical outcomes, and laboratory markers. Patients should be followed up frequently and treated in accordance with their response to the drug therapy. Bariatric surgery may affect the pharmacokinetics of various drugs, due to the resultant anatomical changes and the substantial weight loss. Therefore, there is a need to identify those potential changes and adjust patients' medication doses in order to achieve higher efficacy and avoid toxicity.

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来源期刊
Current Nutrition Reports
Current Nutrition Reports Agricultural and Biological Sciences-Food Science
CiteScore
7.70
自引率
2.00%
发文量
59
期刊介绍: This journal aims to provide comprehensive review articles that emphasize significant developments in nutrition research emerging in recent publications. By presenting clear, insightful, balanced contributions by international experts, the journal intends to discuss the influence of nutrition on major health conditions such as diabetes, cardiovascular disease, cancer, and obesity, as well as the impact of nutrition on genetics, metabolic function, and public health. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 25 internationally diverse members reviews the annual table of contents, suggests topics of special importance to their country/region, and ensures that topics and current and include emerging research.
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