Thiazide diuretic management post-bariatric surgery Taylor Vanderpool, Natalie Kurtkaya Ralph H. Johnson VA Medical Center (Ambulatory Care) - Charleston, SC
Background/Purpose: Bariatric surgery has been found to have significant impacts on morbidity and mortality with evidence that it may improve or resolve more than 40 obesity-related diseases and conditions including type 2 diabetes, heart disease, and hypertension. Per the Ralph H. Johnson VA Medical Center _x001C_Weight Loss Surgery Guide,_x001D_ patients are advised that a thiazide diuretic may be discontinued immediately following surgery due to increased risk of dehydration and low blood pressure. At the Ralph H. Johnson VA Medical Center pharmacists serve an integral member of the bariatric surgery team and have noted that thiazide diuretics are often discontinued relatively soon after bariatric surgery and may even be related to adverse drug events in some cases. However, based on a review of the literature, there is no published evidence for the continuation or discontinuation of thiazide diuretics following bariatric surgery.
Methodology: A data query identified patients who underwent bariatric surgery between January 1, 2011 and September 1, 2018 and had filled a thiazide diuretic within 180 days of the surgery date. Retrospective chart review was performed to identify the rate of continuation following bariatric surgery, baseline characteristics, comorbidities, concomitant blood pressure medications, and blood pressure during the follow-up period.
Presentation Objective: To estimate clinical necessity and to evaluate safety considerations of the use of thiazide diuretics following bariatric surgery to provide guidance for clinical management of these agents during the pharmacy pre-operative review.
Self-Assessment: Which of the following is a potential adverse drug event related to a thiazide diuretic?
