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减肥手术后药物和补充剂的药理动力学变化:系统性审查和元分析
Fannie Lajeunesse-Trempe1,2, Dominika Okroj3, Eduard Ostarijas4
1Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
概括
腹腔外科手术会影响口服药物和补充剂的药理动力学 (PK),其中类醇显示出显著的变化. 需要更多的研究来确定手术后患者安全的最佳实践.
科学领域:
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
- 临床药房 临床药房
背景情况:
- 腹腔外科手术显著改变胃肠道生理学.
- 了解它对药物吸收和新陈代谢的影响对于患者护理至关重要.
研究的目的:
- 系统地评估减肥手术对口服药物和补充剂的药代动力学 (PK) 参数的影响.
- 为了确定特定的药物和补充剂与改变了手术后的PK配置文件.
主要方法:
- 系统地对文献数据库进行文献搜索.
- 从确定的研究中对聚合效应估计的元分析.
- 随机效应建模以解释异质性.
主要成果:
- 分析了58项涉及1985名参与者的研究,评估了40种药物和6种补充剂.
- 在手术后,降醇的清除率降低,最大度增加,半衰期延长.
- 对于阿托瓦斯塔丁,奥梅普拉,,费里丁和补充剂,没有观察到显著的PK变化.
结论:
- 目前的研究存在显著的异质性,限制了许多PK参数的确发现.
- 在53种评估的药物和补充剂中,有18种显示了手术后的PK变化.
- 进一步的前性研究对于指导临床实践和确保腹术后患者安全至关重要.
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