Drug absorption from oral formulations in patients with short bowel syndrome: a comprehensive update of the literature

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Abstract

INTRODUCTION: Drug absorption is often altered and typically diminished in patients with short bowel syndrome (SBS). It is important to understand the patient's gastrointestinal anatomy, the absorptive capacity of the remaining bowel, and the physicochemical and pharmacokinetic properties of the drug to optimize oral pharmacotherapy.

AREAS COVERED: The primary focus was to provide an updated understanding of the absorption of various drugs in patients with short bowel syndrome. Forty-seven studies covering 13 different drug classes were included in the review and study details, patient characteristics, drug characteristics and pharmacokinetic findings were summarized for each drug class.

EXPERT OPINION: Improving and simplifying drug treatment in patients with SBS have high priority, but the patients are multi diseased so knowledge regarding absorption of drugs as e.g. antithrombotic agents, immunosuppressants is urgently needed. Therefore, it is crucial to advance our understanding of the fundamental factors involved in drug absorption, spanning from drug design to pathophysiology. With the growing knowledge in drug design and gastrointestinal pathophysiology, we anticipate the development of computer models that can accurately predict optimal absorption in the future.

Original languageEnglish
JournalExpert Opinion on Drug Metabolism & Toxicology
Volume19
Issue number9
Pages (from-to)577-600
Number of pages24
ISSN1742-5255
DOIs
Publication statusPublished - Sept 2023

Keywords

  • Bioavailability
  • drug absorption
  • intestinal failure
  • pharmacokinetic
  • short bowel syndrome

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