Schlatter Joël
Department of Pharmacy, Hôpital Jean Verdier - APHP, Hôpitaux Universitaires de Paris-Seine-Saint-Denis, Bondy, France.
Obes Facts. 2017;10(2):118-126. doi: 10.1159/000449508. Epub 2017 Apr 22.
Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs.
We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery.
The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters. Bariatric surgery could potentially result in a transient change in the absorption of drugs such as analgesics, antibiotics, antiarrhythmics, anticoagulants, psychotropic, and oral contraceptive drugs. Effective contraception is especially critical in the postoperative period, and implants might be representing a safe contraceptive method in women undergoing bariatric surgery.
Each drug will have to be evaluated with respect to its site of absorption and its mechanism of absorption, with special attention on parameters influencing the effectiveness of the absorption processes.
减肥手术为肥胖患者提供了一种高效的治疗方式。一些手术，如胃肠旁路手术，会改变正常胃肠道，可能影响口服药物的吸收。
我们评估了相关文献，以确定减肥手术后口服药物尤其是口服避孕药的使用是否有效且恰当。
减肥手术后，药物的生物利用度可能会受到改良后介质的溶解度和pH值以及胃肠道转运蛋白丢失的影响。减肥手术可能会导致镇痛药、抗生素、抗心律失常药、抗凝药、精神药物和口服避孕药等药物吸收的短暂变化。有效的避孕措施在术后阶段尤为关键，对于接受减肥手术的女性而言，植入物可能是一种安全的避孕方法。
每种药物都必须根据其吸收部位和吸收机制进行评估，尤其要关注影响吸收过程有效性的参数。
