Pharmacology & Medication Management Flashcards
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Read the first 7 Pharmacology & Medication Management flashcards as text
Which form of vitamin B12 supplementation is most appropriate for patients who have undergone Roux-en-Y gastric bypass due to reduced intrinsic factor availability?
Answer: Sublingual or injectable B12
After RYGB, reduced intrinsic factor production impairs oral B12 absorption, making sublingual or injectable routes more reliably effective.
After Roux-en-Y gastric bypass, which calcium supplement formulation is preferred over calcium carbonate?
Answer: Calcium citrate
Calcium citrate is preferred after RYGB because it does not require gastric acid for absorption, unlike calcium carbonate.
Which class of medications should be avoided after bariatric surgery due to significantly increased risk of anastomotic (marginal) ulcers?
Answer: NSAIDs
NSAIDs inhibit prostaglandin synthesis and increase the risk of marginal ulcers and GI bleeding at the anastomosis in bariatric patients.
Extended-release medication formulations are generally contraindicated after bariatric surgery primarily because:
Answer: Altered GI anatomy and transit time result in unpredictable drug release and absorption
Extended-release formulations rely on intact GI anatomy for timed drug release; bariatric procedures alter this anatomy, making absorption unpredictable.
A patient who underwent sleeve gastrectomy reports decreased effectiveness of her oral contraceptive pills. What is the most appropriate nursing action?
Answer: Counsel the patient to use an alternative or backup contraceptive method
Altered gastric emptying and absorption after bariatric surgery can reduce oral contraceptive reliability, so alternative or backup contraception should be recommended.
Which iron supplement formulation is most appropriate for bariatric patients in the post-operative period?
Answer: Liquid or chewable iron taken with vitamin C
Liquid or chewable iron with vitamin C maximizes bioavailability; enteric-coated and slow-release forms are poorly absorbed after bariatric surgery.
How long after bariatric surgery should metformin typically be withheld before safely resuming therapy?
Answer: Until oral intake is adequate, usually one to two weeks
Metformin is held perioperatively and restarted only when adequate oral intake and hydration are established to minimize the risk of lactic acidosis.