The Impact of Bariatric Surgery on the Pharmacokinetic Behaviors of Orally Administered Drugs
Ahmed Ahmed
Department of Oesphogastric and General Surgery, University Hospitals of Leicester, Leicester, UK.
Ali S. Heyam
Department of Pharmaceutics, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan.
Gamal O. Elhassan
Department of Pharmaceutics, Unaizah College of Pharmacy, Qassim University, Unaizah, KSA.
Hifny Abdelhameed
Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Sari T. S. Alhoufie
Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munwarah, KSA.
Saad S. Alqahtani
Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, KSA.
Khalid O. Alfarouk
Hala Alfarouk Cancer Center, Khartoum, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Bariatric surgery is considered an appropriate method in cases of obesity, such as severe or comorbidities obesity. However, the number of patients requiring bariatric surgery is growing constantly and rapidly. Opposing that, the anatomical modifications of the gastrointestinal tract often lead to a significant alteration in the pharmacokinetics of orally administered drugs in terms of absorption of drugs and the bioavailability of oral medications required after the surgery. The current study investigates the correlation between reduced body mass following bariatric surgery and the bioavailability of orally administered drugs. Therefore, it is required to warrant through clinical studies that help establish guidelines related to common oral drugs prescribed and monitor the medications that exhibit a small therapeutic window that should be assessed, excluding the clinical endpoint. Furthermore, the use of pharmacokinetic modeling based on a mechanical method to simulate the multivariate nature observed while changes occur during the exposure of drugs will help to serve as an essential tool to understand further the trends in oral exposure of drugs in postoperative cases develop practical clinical guidance.
Keywords: Bariatric surgery, bioavailability, GIT, pharmacokinetic