Bariatric surgeries induce structural changes that can alter the absorption of drugs in patients already at risk of polypharmacy. This scoping review aimed to explore pharmacokinetic changes of orally administered drugs in patients post‐bariatric surgery, and assess the quality and level of bias. Electronic databases were searched for articles relating to bariatric surgery and pharmacokinetics published between 1998 and 2019. Pre‐post studies reporting on pharmacokinetic parameters were included, and the Newcastle‐Ottawa Scale was used to assess risk‐of‐bias. A total of 21 studies were included in this review, and changes in absorption were reported in all included studies across 29 drugs. In 11 studies, this change was reported as statistically significant (p<.05), while six reported a nonsignificant change. More drugs exhibited a shorter Tmax and higher Cmax after surgery than otherwise, however changes in AUC were variable. Four studies were assessed as having fair quality while the remainder of the included studies were of good quality and low risk‐of‐bias. Bariatric surgery alters the absorption of drugs and several mechanisms are implicated to be responsible. Short and long‐term monitoring is recommended in patients post‐surgery for clinical changes in response to medications. Future research with a higher number of participants and greater control of variables, such as concurrent medications, malabsorptive disorders, and body composition should be considered.

中文翻译：

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aria门手术后的药代动力学变化：范围回顾。

减肥手术会诱发结构变化，从而可能改变已经处于多药风险的患者的药物吸收。这项范围界定的审查旨在探讨重症患者术后口服药物的药代动力学变化，并评估偏倚的质量和水平。在电子数据库中搜索了1998年至2019年之间发表的有关减肥手术和药物代谢动力学的文章。包括了有关药物代谢动力学参数的事前研究，并使用了纽卡斯尔-渥太华量表来评估偏倚风险。该评价共纳入21项研究，所有纳入的研究均报告了29种药物的吸收变化。在11项研究中，据报道该变化具有统计学显着性（p <.05），而六项研究则无统计学意义。与其他方法相比，更多的药物在手术后表现出更短的Tmax和更高的Cmax，但是AUC的变化是可变的。评估了四项研究的质量，而其余研究质量良好且偏见风险低。减肥手术改变了药物的吸收，牵涉到几种机制。对于患者对药物反应的临床变化，建议在术后进行短期和长期监测。未来的研究应考虑更多的参与者和更多的变量控制，例如同时用药，吸收不良和身体组成。评估了四项研究的质量，而其余研究质量良好且偏见风险低。减肥手术改变了药物的吸收，牵涉到几种机制。对于患者对药物反应的临床变化，建议在术后进行短期和长期监测。未来的研究应考虑更多的参与者和更多的变量控制，例如并发用药，吸收不良和身体组成。评估了四项研究的质量，而其余研究质量良好且偏见风险低。减肥手术改变了药物的吸收，牵涉到几种机制。对于患者对药物反应的临床变化，建议在术后进行短期和长期监测。未来的研究应考虑更多的参与者和更多的变量控制，例如同时用药，吸收不良和身体组成。