Bibliographic record
Abstract
OBJECTIVE: To evaluate the effect of bariatric surgery on the pharmacokinetics of medications. DATA SOURCES: EMBASE (1980-September 2011), PubMed (1947-September 2011), MEDLINE (1948-September 2011), and International Pharmaceutical Abstracts (1970-September 2011) were searched for the following terms: gastric bypass or stomach bypass or bariatric surgery, and pharmacokinetic. STUDY SELECTION AND DATA EXTRACTION: All English-language primary literature that reported pharmacokinetic parameters for orally dosed medications in post-bariatric surgery patients was evaluated, with the exception of studies involving the jejunoileal bypass method. DATA SYNTHESIS: Worldwide, the incidence of obesity is increasing and so are options for managing it, including bariatric surgery. Major alterations to the physical structure of the gastrointestinal tract may cause changes in pharmacokinetic parameters of oral medications, which theoretically could lead to increased or decreased drug exposure. We reviewed 11 prospective trials, 5 of which were available only as abstracts and all of which were small with relatively low power (n = 6-36). The studies were split almost equally between using subjects as their own controls or using separate control subjects; 1 study used historical data as the control. Results were varied, highlighting the multifactorial nature of pharmacokinetics. Drugs such as atorvastatin, which undergo presystemic intestinal metabolism via CYP3A, may show increased bioavailability, whereas those such as amoxicillin, which rely on transport mediators, may be decreased. Most of the studies lacked sufficient power to show significant changes in post-bariatric surgery patients. CONCLUSIONS: Bariatric surgical procedures may result in altered pharmacokinetic parameters, but the literature is lacking in sufficient quantity and quality of studies to make solid conclusions and recommendations. Until more studies of sufficient power are completed, clinicians should closely monitor these patients in the immediate and distant postsurgical period for signs of both drug efficacy and toxicity and adjust their medications as required.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".