Produção Nacional
Revisado por pares
Clinicians' prescribing practices for bariatric surgery patients: is there an issue?
2014; Wiley; Volume: 40; Issue: 1 Linguagem: Inglês
10.1111/jcpt.12217
ISSN1365-2710
AutoresB. L. da S. Guedes, Maiara Camotti Montanha, Jorge Juarez Vieira Teixeira, Andréa Diniz, S. R. B. Silva, Isolde Terezinha Santos Previdelli, Daoud NASSER, Sérgio Yamada, Elza Kimura,
Tópico(s)Diabetes Treatment and Management
ResumoJournal of Clinical Pharmacy and TherapeuticsVolume 40, Issue 1 p. 104-109 Pharmacokinetics Clinicians' prescribing practices for bariatric surgery patients: is there an issue? B. L. da S. Guedes MSc, B. L. da S. Guedes MSc Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorM. C. Montanha BPharm, M. C. Montanha BPharm Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorJ. J. V. Teixeira PhD, J. J. V. Teixeira PhD Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorA. Diniz PhD, A. Diniz PhD Pharmacy Department, State University of Maringa, Paraná, BrazilSearch for more papers by this authorS. R. B. Silva MSc, S. R. B. Silva MSc Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilSearch for more papers by this authorI. Previdelli PhD, I. Previdelli PhD Statistic Department, State University of Maringa, Paraná, BrazilSearch for more papers by this authorD. Nasser MD, D. Nasser MD Regional University Hospital of Maringa, Parana, BrazilSearch for more papers by this authorS. S. Yamada MD PhD, S. S. Yamada MD PhD Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilSearch for more papers by this authorE. Kimura PhD, Corresponding Author E. Kimura PhD orcid.org/0000-0002-6466-5074 Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, Brazil Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilCorrespondence: Prof. Dr. Elza Kimura, Hospital Universitário Regional de Maringá, Núcleo de Pesquisa Clínica e Bioequivalência. Avenida Mandacarú, 1590, CEP 87083-240 Maringa, Parana, Brazil. Tel.: +55 44 3011 9202; fax: +55-44-3011-9137; e-mail: [email protected]Search for more papers by this author B. L. da S. Guedes MSc, B. L. da S. Guedes MSc Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorM. C. Montanha BPharm, M. C. Montanha BPharm Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorJ. J. V. Teixeira PhD, J. J. V. Teixeira PhD Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, BrazilSearch for more papers by this authorA. Diniz PhD, A. Diniz PhD Pharmacy Department, State University of Maringa, Paraná, BrazilSearch for more papers by this authorS. R. B. Silva MSc, S. R. B. Silva MSc Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilSearch for more papers by this authorI. Previdelli PhD, I. Previdelli PhD Statistic Department, State University of Maringa, Paraná, BrazilSearch for more papers by this authorD. Nasser MD, D. Nasser MD Regional University Hospital of Maringa, Parana, BrazilSearch for more papers by this authorS. S. Yamada MD PhD, S. S. Yamada MD PhD Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilSearch for more papers by this authorE. Kimura PhD, Corresponding Author E. Kimura PhD orcid.org/0000-0002-6466-5074 Post-Graduate Program in Bioscience and Physiopathology, State University of Maringa, Paraná, Brazil Regional University Hospital of Maringa, Clinical Research and Bioequivalence Nucleus, Maringa, Paraná, BrazilCorrespondence: Prof. Dr. Elza Kimura, Hospital Universitário Regional de Maringá, Núcleo de Pesquisa Clínica e Bioequivalência. Avenida Mandacarú, 1590, CEP 87083-240 Maringa, Parana, Brazil. Tel.: +55 44 3011 9202; fax: +55-44-3011-9137; e-mail: [email protected]Search for more papers by this author First published: 10 October 2014 https://doi.org/10.1111/jcpt.12217Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Summary What is known and objectives Patients undergoing Roux-en-Y gastric bariatric (RYGB) surgery present a reduced absorption site, and special attention should therefore be taken when prescribing oral-dosage forms. This study was carried out to investigate the extent to which non-bariatric clinicians are aware of this issue when prescribing medicines for this population, and what type of information is available to aid them in their decision-making. Methods Two questionnaires were created, one for non-bariatric clinicians and another for their patients who had undergone RYGB surgery, to gather information about the prescription practices for this population. Additionally, a literature search of pharmacokinetic studies on bariatric patients and recommended prescription practices was carried out. Results and discussion Of the 62 non-bariatric clinicians surveyed, 50% believed RYGB surgery interferes with drug absorption; however, 68% still prescribed tablets as the first choice form of dosage. Young clinicians (35%) were less likely to believe that RYGB surgery could affect drug absorption than experienced clinicians (43%). The main reasons for changing dosage forms were patient complaints about efficacy or difficulty in swallowing tablets. Of the 73 patients, 43 were taking drugs in tablet form after the surgery, 24 of whom had health issues unrelated to the surgery. None of the journals read by the clinicians contained pharmacokinetics (PK) studies involving bariatric surgery patients or presented recommendations for the prescription of oral-dosage forms for this population. The literature search revealed a total of 22 drugs that had undergone PK studies in RYGB patients. Fifteen of them were reported to have decreased effects, 12 of which were administered as tablets. What is new and conclusion There is still a relative lack of clinical evidence to guide clinicians when prescribing medicines for bariatric patients. 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