Effect of body position on rate of drug absorption - Tips from Other Journals

Date: June, 1992

Many factors influence the rate of gastric emptying and drug absorption in patients who have taken an oral overdose. Limited studies have evaluated the effect of body position on the rate of gastric emptying, but the effects of drug absorption have not been studied. Vance and associates conducted a study to determine whether body position influences the rate of drug absorption.

The study included six male and six female volunteers who were healthy and were not taking medications that affect gastrointestinal function. Following eight hours of fasting, subjects were given 80 mg per kg of acetaminophen. Subjects were then randomly placed in one of five positions; left lateral decubitus, right lateral decubitus, supine, prone or sitting. Acetaminophen levels were measured at 15-minute intervals. The trial was repeated until each subject had been evaluated in all five positions. Subjects underwent a three-day washout period between trials.

Mean drug absorption as represented by a two-hour area under the curve was calculated for each body position. The mean total area under the curve was lowest for the left lateral decubitus position (6,006 mg per L per minute) but did not differ significantly from that for the supine position (6,649 mg per L per minute). Both values were significantly lower than the values for the prone position (7,432 mg per L per minute), the right lateral decubitus position (8,950 mg per L per minute) and the sitting position (8,608 mg per L per minute).

The authors conclude that the left lateral decubitus position delays drug absorption. This position also prevents aspiration. They recommended that overdose patients be placed in the left lateral decubitus position for management before hospital admission and initial management in the emergency department. (Annals of Emergency Medicine, March 1992, vol. 21, p. 243.)

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