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Bariatric Surgery – Pharm Study Guide Questions
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Bariatric Surgery – Pharm Study Guide Questions
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Bariatric Surgery – Pharm Study Guide Questions1.State the BMI indication for bariatric surgery and the need for a serious co
morbidity: · Metabolic and bariatric surgery (MBS) is recommended for
individuals with a body mass index (BMI) e35 kg/m2, regardless of
presence, absence, or severity of co-morbidities.
· MBS should be considered for individuals with metabolic disease
and BMI of 30-34.9 kg/m2.
2.Identify the contraindications to bariatric surgery.: · Bariatric
procedures should not be performed for glycemic or lipid control, or
for cardiovascular risk reduction independent of the BMI parameters.
3.Other medical or psychiatric conditions that preclude a bariatric
surgical procedure include: · Untreated major depression or psychosis
· Uncontrolled and untreated eating disorders (e.g., bulimia)
· Current drug and alcohol abuse
· Severe cardiac disease with prohibitive anesthetic risks
· Severe coagulopathy
· Inability to comply with nutritional requirements including life-long
vitamin replace- ment
4.State the goal of pre-surgical psychologic assessment for a patient con-
templating bariatric surgery: to identify any previously undiagnosed
psychiatric disorders and determine if an operative candidate is able
and willing to make the necessary lifestyle changes required for
sustainable weight
5.Identify the major assessment areas that should be included in
the pre-surgery assessment.: · Nutritional assessment
o To identify deficiencies—vitamins, iron, calcium
o Weight history and eating behaviors
o Identify maladaptive eating styles
· Medication History
· Medical assessment to ensure that they can tolerate the surgery and
that manage- ment of co-morbid diseases are optimized
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,o assess for comorbid illnesses, such as hypertension, diabetes,
obstructive sleep apnea (OSA), malnutrition, restrictive lung disease, and
appropriateness as a sur-
gical candidate.
o Screening: for apnea, cardiac risk, peptic ulcer disease, valvular
disease in people who have taken weight loss medication, liver disease,
renal disease, cancer
· Lab studies to evaluate kidneys, liver, diabetes control, hypertension,
lipids, gout, thyroid disease
· Anesthetic risk assessment
6.Identify the 2 mechanisms of weight loss due to bariatric surgery: ·
Malab- sorption
· Restriction.
7.· Restriction.: o Restrictive procedures limit caloric intake by reducing
the stom- ach's reservoir capacity
o Both limit solid food intake by restriction of stomach size as the only
mechanism of action, leaving the absorptive function of the small
intestine intact.
8.· Malabsorption: o decrease the effectiveness of nutrient absorption by
shorten- ing the length of the functional small intestine, either through
bypass of the small bowel absorptive surface area or diversion of the
biliopancreatic secretions that facilitate absorption.
o Jejunoileal bypass (JIB) and the biliopancreatic diversion (BPD) are
examples of malabsorptive procedures.
o Profound weight loss can be achieved by a malabsorptive operation,
depending upon the effective length of the functional small bowel
segment.
o the benefit of superior weight loss can be offset by significant metabol
compli- cations, such as protein calorie malnutrition and various
micronutrient deficiencies.
9.Hydration: · High priority
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, · the vicious cycle of dehydration and nausea can occur
· dehydration often results in emergency room visits
· Most common reason for readmission
10.control of pain inpatient: usually done with an opioid like oral
oxycodone
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