Porażka Joanna, Karbownik Agnieszka, Murawa Dawid, Spychała Arkadiusz, Firlej Magdalena, Grabowski Tomasz, Murawa Paweł, Grześkowiak Edmund, Szałek Edyta
Department of Clinical Pharmacy and Biopharmacy, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.
Department of Clinical Pharmacy and Biopharmacy, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.
Pharmacol Rep. 2017 Apr;69(2):296-299. doi: 10.1016/j.pharep.2016.11.010. Epub 2016 Dec 9.
Total and partial gastric resection may affect the pharmacokinetics of drugs, especially orally administered a few days after surgery. Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) broadly used to treat postoperative pain, including patients after gastric resection. The aim of the research was to analyse the pharmacokinetics (PK) of orally administered ketoprofen in patients after gastrectomy.
The research was carried out on two groups of patients after total (TG; Roux-Y procedure) and partial (PG; Billroth II procedure) gastrectomy. The patients in group TG (n=15; mean [SD] age 61.86 [14.15] years; and BMI 24.20 [3.73] kg/m) and group PG (n=5; mean [SD] age 62.40 [16.80] years; and BMI 23.98 [3.45] kg/m) received ketoprofen in a single oral dose of 100mg. The measurement of ketoprofen plasma concentrations was made by means of the HPLC (high performance liquid chromatography) method.
The PK parameters in group TG and PG were as follows: maximum plasma concentration (C), 3.42 [0.99] and 4.66 [0.81] mg/l (p=0.0220); area under the plasma concentration-time curve from zero to infinity (AUC), 9.12 [2.78] and 9.17 [2.87] mg×h/ml (p=0.9734); area under the first moment curve from zero to the time of infinity (AUMC), 25.95 [8.52] and 26.53 [11.43] mg×h/l (p=0.9056); time to reach maximum concentration (t), 0.47 [0.25] and 0.55 [0.27] h (p=0.5327), respectively.
Lower concentrations of ketoprofen in patients after gastrectomy suggest that it might be necessary to apply higher dose of the analgesic.
全胃切除术和部分胃切除术可能会影响药物的药代动力学，尤其是在术后几天口服给药时。酮洛芬是一种广泛用于治疗术后疼痛的非甾体抗炎药（NSAID），包括胃切除术后的患者。本研究的目的是分析胃切除术后患者口服酮洛芬的药代动力学（PK）。
对两组接受全胃切除术（TG组；Roux-Y手术）和部分胃切除术（PG组；毕罗Ⅱ式手术）的患者进行了研究。TG组（n = 15；平均[标准差]年龄61.86 [14.15]岁；体重指数24.20 [3.73] kg/m²）和PG组（n = 5；平均[标准差]年龄62.40 [16.80]岁；体重指数23.98 [3.45] kg/m²）的患者接受了单次口服100mg酮洛芬。采用高效液相色谱（HPLC）法测定酮洛芬的血浆浓度。
TG组和PG组的PK参数如下：最大血浆浓度（Cmax）分别为3.42 [0.99]和4.66 [0.81] mg/l（p = 0.0220）；血浆浓度-时间曲线从零到无穷大的面积（AUC）分别为9.12 [2.78]和9.17 [2.87] mg×h/ml（p = 0.9734）；从零到无穷大的一阶矩曲线下面积（AUMC）分别为25.95 [8.52]和26.53 [11.43] mg×h/l（p = 0.9056）；达到最大浓度的时间（tmax）分别为0.47 [0.25]和0.55 [0.27] h（p = 0.5327）。
胃切除术后患者体内酮洛芬浓度较低，提示可能有必要应用更高剂量的该镇痛药。
