Long-term pharmacotherapy considerations in the bariatric surgery patient

Abstract

Pharmacists have an increasing role in the chronic management of the bariatric surgery patient due to their knowledge of medication dosage forms and expertise in disease states affected by bariatric surgery.

Comparison of Bioavailability of Single‐Dose Extended‐Release Venlafaxine Capsules in Obese Patients Before and After Gastric Bypass Surgery

“…One possible contributing factor proposed to account for psychosocial challenges after bariatric surgery is malabsorption of antidepressants. Most patient educational materials, review articles, and guidelines for medication administration after RYGB recommend routinely avoiding ER preparations because of concerns that the medication may pass through the gastrointestinal tract before satisfactory absorption can occur . This practice can lead to adherence issues for patients and unanswered questions by prescribers about the clinical relevance of this practice.…”

“…Most patient educational materials, review articles, and guidelines for medication administration after RYGB recommend routinely avoiding ER preparations because of concerns that the medication may pass through the gastrointestinal tract before satisfactory absorption can occur. [9][10][11] This practice can lead to adherence issues for patients and unanswered questions by prescribers about the clinical relevance of this practice. Following the U.S. Food and Drug Administration guidance for bioavailability and bioequivalence for pharmacokinetic studies, we examined equivalency before and after RYGB.…”

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities

“…However, agents such as phentermine or topiramate may be better suited due to the fact that their mechanisms of action do not appear to overlap with many of the surgical mechanisms . This area has yet to be explored in pediatrics and has sparse literature in adults , which lends it well to a future avenue to improve the robust treatment outcomes provided by bariatric and metabolic surgery.…”

Exploring the Patient-Reported Impact of the Pharmacist on Pre-bariatric Surgical Assessment

“…The pharmacist is a valued resource by patients as part of their pre-surgical assessment, but consideration should be given to further appointments post-surgically to address medication issues following weight loss and changes to health status, to reinforce the importance of life-long vitamin supplementation and management of potential side effects. Currently, the pharmacist role is limited to pre-surgical assessment, but there is potential for pharmacists to become more involved in the management of patients following surgery, particularly in the management of long-term chronic diseases [15]. Further research into the role of pharmacist as an integral part of the MDT in bariatric patient care is recommended, along with ascertaining education and training for this specialist role in practice.…”