Question: Some elderly persons have achlorhydria, or insufficient production of

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Question: Some elderly persons have achlorhydria, or insufficient production of gastric acid. Gastric pH in these individuals may be as high as 5-6. Ketonconazole has been shown to be poorly absorbed in these patients. Please explain why this is. Ketoconazole Case KM is a 30 year old female who was recently prescribed one 200-mg tablet of ketoconazole daily for treatment of a persistent vaginal yeast infection. KM's physician told her to take the ketoconazole tablet with Coca Cola rather than with water because the Coca Cola makes the drug work better". KM does not like Coca Cola, so she called her brother who is a pharmacy student, and asked him what other liquid she can use instead of Coca Cola. Background: Ketoconazole, an antifungal drug, is a weak dibasic compound with pKa values of 2.9 and ctically insoluble in a CI

Explanation / Answer

Ketaconazole requires acidic medium for absorption. When pH is less than 3, there is greater dissolution and absorption of ketaconazole drug. In individuals with achlorhydria, the pH of the stomach is increased. This prevents dissolution of the drug and it's subsequent absorption.

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