Drug use in patients with short bowel syndrome and intestinal failure

INTRODUCTION

In patients with short bowel syndrome (SBS), severe malabsorption may cause a need for parenteral support and, by definition, these patients suffer from SBS intestinal failure. Absorption of oral medications is likely diminished in patients with SBS intestinal failure and higher than normal doses may be required to achieve sufficient pharmacologic effect. We investigated the prescription patterns and oral dosages in a well-defined population of patients with non-malignant SBS intestinal failure.

METHODS

This was a cross-sectional analysis based on a cohort of adult patients with SBS intestinal failure treated with home parenteral support and registered in 2016 at the Department of Gastroenterology at the Copenhagen University Hospital - Rigshospitalet. The patients' clinical data and prescription patterns were extracted from electronic medical and medications records.

RESULTS

The patients in our cohort (n = 74) were primarily females (58%), the median age was 63 years (interquartile range (IQR): 52-72 years) and the median BMI was 22 kg/m2 (IQR: 19-26 kg/m2). Each patient was treated with a median of eight drugs (range: 1-20). Most (75%) of the medications were administered orally. Only codeine, levothyroxine and loperamide were prescribed in higher dosages than recommended in their product labelling. All medication-treated patients were prescribed between one and four different analgesics.

CONCLUSION

In our single-centre cohort of patients with SBS intestinal failure, orally administered medications were generally prescribed in recommended dosages.

FUNDING

none Trial registration. Approved by the Danish Data Protection Agency (BFH-2016-058, I-Suite no.: 04906) and the Danish Patient Safety Authority (3-3013-1884/1/).

[Respiratory dyskinesia]

In this review, we discuss respiratory dyskinesia, which is a rare adverse reaction to antipsychotic medications. The condition may mimic psychogenic hyperventilation syndrome or other respiratory or cardiac disorder. Respiratory dyskinesia is mostly seen in patients with tardive dyskinesia but may precede manifestations of tardive dyskinesia. If a patient receiving antipsychotic medication presents with symptoms of tachypnoea or acute respiratory distress, the possibility of respiratory dyskinesia should be considered, since it is a potentially reversible condition.

[Metoclopramide-induced respiratory dyskinesia]

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