Medications and the Ostomate

Area of Science:

• Pharmacology
• Gastroenterology
• Patient Care

Background:

• Over one million Americans have undergone ostomy surgery, with over 130,000 new procedures annually.
• Ostomy patients present unique challenges regarding medication efficacy and safety.
• Pharmacists require specialized knowledge to manage ostomates' drug therapy effectively.

Purpose of the Study:

• To review the application of pharmacokinetic and pharmacodynamic principles in ostomy patient medication management.
• To highlight critical considerations for pharmacists caring for individuals with ostomies.
• To provide a foundation for optimizing drug therapy in this patient population.

Main Methods:

• Review of basic pharmacokinetic principles (absorption, distribution, metabolism, excretion) in the context of ostomy.
• Review of basic pharmacodynamic principles (drug effects on the body) relevant to ostomy patients.
• Discussion of specific clinical issues encountered in ostomy medication management.

Main Results:

• Altered drug absorption can occur due to changes in gastrointestinal transit time and surface area post-ostomy.
• Pharmacokinetic and pharmacodynamic principles must be adapted for ostomy patients to ensure therapeutic outcomes.
• Common issues include challenges with controlled-release formulations, antibiotic-associated diarrhea, and potential for electrolyte imbalances.

Conclusions:

• Pharmacists play a vital role in optimizing medication use for ostomy patients.
• Understanding drug disposition and effects in ostomates is crucial for preventing adverse events and ensuring treatment success.
• Further research and education are needed to address the complexities of pharmacotherapy in individuals with ostomies.