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Effect of delayed esophageal transit on acetaminophen absorption
Clinical Pharmacology and Therapeutics
|January 1, 1985
Summary
Swallowing acetaminophen tablets while lying down can delay esophageal transit, reducing drug absorption and effectiveness. Standing improves absorption, ensuring faster pain relief.
Area of Science:
- Pharmacokinetics
- Gastroenterology
Background:
- Acetaminophen is a widely used analgesic.
- Drug absorption can be influenced by patient posture and esophageal transit time.
Purpose of the Study:
- To investigate the effect of patient posture on acetaminophen absorption.
- To determine if delayed esophageal transit impacts acetaminophen's pharmacokinetic profile.
Main Methods:
- Twenty patients awaiting cardiac catheterization were given a tablet containing acetaminophen and barium sulfate.
- Tablet transit through the esophagus was monitored using fluoroscopy in patients swallowing supine versus standing.
- Plasma acetaminophen concentrations were measured to assess absorption kinetics.
Main Results:
- Delayed esophageal transit occurred in 10 of 11 subjects swallowing supine.
- Subjects swallowing standing experienced immediate gastric entry.
- Delayed transit resulted in lower initial acetaminophen absorption (AUC 0-60 min), lower peak plasma concentrations, and a delayed Tmax.
Conclusions:
- Patient posture significantly affects esophageal transit and subsequent acetaminophen absorption.
- Delayed absorption due to supine posture may reduce analgesic effectiveness.
- Patients should swallow tablets while standing with ample water for optimal absorption.