Key result
Swallowing an acetaminophen tablet while supine delayed esophageal transit, resulting in lower initial absorption and a lower peak plasma concentration that occurred 70 minutes later than standing.
Why the study?
Does swallowing a tablet while supine compared to standing affect the absorption of acetaminophen in patients awaiting cardiac catheterization?
Observational (n=20)
Does swallowing a tablet while supine compared to standing affect the absorption of acetaminophen in patients awaiting cardiac catheterization?
Swallowing tablets while supine delays esophageal transit and decreases the rate and extent of early acetaminophen absorption, suggesting patients should take tablets while standing.
Supine swallowing was associated with delayed acetaminophen absorption pre-catheterization; hypothesis-generating for posture effects on oral drug bioavailability.
Twenty patients awaiting cardiac catheterization swallowed a single tablet containing acetaminophen and barium sulfate. The first 11 subjects swallowed the tablet while supine; its progress down the esophagus was followed by fluoroscopy. In 10 of these subjects, transit of the tablet was delayed in the esophagus. The other nine subjects swallowed the tablet while standing; it entered the stomach immediately. The plasma concentration profile of acetaminophen was measured in all subjects. When there was delayed esophageal transit of tablets, the initial absorption of acetaminophen (measured as the AUC over the first 60 min) was lower than that after normal esophageal transit of tablets. The peak plasma acetaminophen concentration was also lower and occurred on average 70 min later when transit was delayed. These kinetic changes decrease the effectiveness of acetaminophen as an analgesic. We recommend that, to ensure rapid and complete drug absorption, patients be advised to swallow tablets with a large amount of water while standing.
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Channer et al. (1985) conducted an observational in awaiting cardiac catheterization (n=20). Swallowing tablet while supine vs. Swallowing tablet while standing was evaluated on Initial absorption of acetaminophen (AUC over the first 60 min). Swallowing an acetaminophen tablet while supine delayed esophageal transit, resulting in lower initial absorption and a lower peak plasma concentration that occurred 70 minutes later than standing.
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