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Help Adjust Chronic Meds After Weight Loss Surgery

front 1

Meds to avoid in bariatric patients

back 1

  • Avoid Enteric-Coated or ER meds for at least 8 weeks after surgery...due to possible erratic absorption
  • Avoid GI irritants: such as NSAIDS and biphosphonates
  • Avoid systemic corticosteroids

front 2

Meds are safe to be used in bariatric patients

back 2

  • Crushable tabs, caps that can be opened or liquids
  • Liquid forms that are low in in sugar...to reduce the risk of dumping syndrome (diarrhea, abdominal cramps)
  • Advise adding PPI if NSAID is necessary

front 3

Meds to avoid in patients with diabetes

back 3

  • Suggest stopping sulfonylureas: Glipizie, Glimeperide, Glyburide

front 4

Insulin in patients with diabetes

back 4

  • Recommend stopping or reducing mealtime dose by at least 50%..and basal insulin by 50-70%

front 5

Antihypertensives in bariatric patients

back 5

  • Recommend reducing dose if needed
  • But ensure meds for comorbid conditions are continued...such as ACEI/ ARB for kidney protection in pts with diabetes

front 6

Warfarin dose in bariatric pts

back 6

  • Anticipate seeing a lower dose for about 6 months after surgery...partly due to less vitamin K intake
  • Expect to return to pre-surgery dose over several months.
  • Dont generally recommend using direct oral anticoagulant...due to limited data

front 7

Vitamin and mineral supplement

back 7

  • Recommend lifetime adherence

front 8

Bariatric pts with a gallblader

back 8

  • Expect to be on Ursodiol for 6 months post-op....to prevent gallstones due to rapid weight loss