A patient presents with Chronic Myelogenous Leukemia (CML) and treatment is plan

Question

A patient presents with Chronic Myelogenous Leukemia (CML) and treatment is planned with imatinib. The medical history suggests your patient used to be morbidly obese. She has undergone a gastric bypass a year ago, and currently has a normal BMI. Which of the following is correct? 1.If you could get a blood sample analyzed, you could confirm whether systemic exposure is similar to published values. 2.Because she has a normal size now, the normal dose of imatinib can be used. 3.You have no idea what the effect of her specific surgical procedures is on the absorption of imatinib. 4.Like most drugs, imatinib gets absorbed from the intestine, so a “gastric” bypass is not relevant for the absorption of imatinib. 5.A and C

Explanation / Answer

The chemotherapy agent imatanib used to treat number of other malignancies, gastrointestinal stromal tumors (GISTs) and chronic myelogenous leukemia (CML). But the absorption of the drug imatanib was significantly reduced or decreased by a range of 46 % to 60 % after the gastric bypass.The evolution of pharmacokinetics after bariatric surgery, both gastric bypass and bilio-pancreatic diversion, imatinib absorption was highly reuced. So in the given scenario the option A and C are mostly suitable to the given situation.

Correct option: 5. A and C

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