Editing Intestinal Segments and Urinary Diversion (section)

==== <span style="color:#ff0000">Abnormal </span><span style="color:#0000ff">D</span><span style="color:#ff0000">rug metabolism ====
* '''Drug intoxication can occur in patients with urinary intestinal diversion. Drugs more likely to be problematic are those absorbed by the gastrointestinal tract and excreted unchanged by the kidney.''' Thus, the excreted drug is re-exposed to the intestinal segment, which then reabsorbs it, and toxic serum levels develop. '''This has been reported with phenytoin, methotrexate, lithium and theophylline.'''
* Patients receiving chemotherapy who have intestine interposed in the urinary tract have increased toxic effects of chemotherapeutic agents. '''Although chemotherapy is usually well tolerated by patients with conduits, toxicity has been documented in a patient with an ileal conduit.'''
** In patients with continent diversions who are receiving chemotherapy, consideration should be given to draining the pouch while the toxic drugs are being administered.