RX523 Pharmacokinetics in Patients Following GI Resection and Bariatric Surgery

Where does most macronutrient digestion and absorption occur?

Proximal small intestine

Where are most drugs absorbed?

Duodenum and jejunum

Short bowel syndrome

Malabsorptive state caused by physical or functional loss of significant portions of the small intestine

Intestinal failure

Function is insufficient to meet the body's nutrition and hydration needs

What are the pharmacokinetic considerations after bowel resection surgery?

- Gastric acid hypersecretion

- Accelerated gastric emptying time in end-jejunostomy

- Reduced GI transit time

- Reduced gut wall metabolism

- Significantly reduced surface area

- Do not give modified-release drugs

Restrictive bariatric surgery

Reduces the volume of the stomach

Malabsorptive bariatric surgery

Reduces the available intestinal surface area

What are the absorption changes after bariatric surgery?

- Increased stomach pH

- Increased gastric emptying time

- Decreased extent of absorption, bioavailability, and AUC

Which of the following is likely to increase in a patient following a Roux-en-Y procedure?

Gastric pH

Which oral drug dosage form would be potentially ineffective and/or dangerous for patients following bariatric surgery?

Modified-release tablets

Which of the following is likely to increase in a patient with SBS?

Gastric acid secretion

Which bowel resection surgery is most likely to result in SBS?

Jejunostomy