| dc.description.abstract | Drug absorption may be a problem in patients with ostomies and shortened bowel. Malabsorption of
certain drugs and drug products is possible due to the reduction in intestinal surface area as a result of
surgical resection. Clinicians are often unaware of this problem when creating dosing regimens and
there is insufficient literature on this topic. To systematically review published evidence of impaired
drug absorption in patients with ostomy or shortened bowel. To make recommendations to clinicians
for appropriate drug therapy in these patients. Studies were obtained through systematic literature
searches of MEDLINE, SCOPUS, SciFinder Scholar, and SuperSearch databases (1983- 2010) for
English articles with keywords: drug malabsorption, absorption, bioavailability, ostomy, ileostomy,
short bowel, and drug monitoring. Two reviewers independently assessed studies for inclusion. Ten
studies were identified investigating impaired absorption in patients with ostomies or shortened
bowel. Evidence for diminished drug absorption was found in 3/10 studies examining ostomies and
7/10 studies involving shortened bowel, including problems with sixty-five drug products. Drug
malabsorption appears to be more well-known in patients with shortened bowel over patients with
ostomies. More studies are needed to evaluate the effect of potential drug malabsorption in patients
with ostomies. Approaches to further research will be presented. Reduced drug absorption is very likely in patients with ostomies or shortened bowel, especially for sustained-release or extended-release
products, and for poorly absorbed drugs. Individual dose-adjustment, selection of a different
route of administration, and therapeutic monitoring of blood levels by clinicians may also be required. | en_US |
