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Doubts over drug for high potassium - Products containing ion exchange resins have been...

Continuing Education

Each topic is eligible for one credit, NZ College of Pharmacists.

Deadline: Friday, March 26, 2010, Any submissions received after deadline date will not be processed.

Article: Bariatric Surgery

For last month's answers click here.

Biochemistry of Alzheimer’s disease (AD)The production and accumulation of ß-amyloid peptide is one of the hallmarks of AD.

Oxidative tissue injury and lipid peroxidation are not involved in the neurotoxicity observed in AD.

Cerebral metabolism is relatively unaffected in individuals with AD.

Conventional therapy for ADAricept® (donepezil hydrochloride) has demonstrated beneficial effects in the peripheral and central nervous systems.

The efficacy of cholinesterase inhibitors is limited to individuals with mild to moderate AD.

Ebixa® (memantine hydrochloride) does not slow or reverse the neurodegenerative processes of AD.

a-Lipoic acid (LA)LA is an important micronutrient and a powerful antioxidant.

LA is only soluble in fats.

The reduced form of LA (DHLA) acts as the antioxidant and is responsible for reducing the oxidised form of other antioxidants.

Benefits of LA in ADOne of the mechanisms by which LA improves neurotransmission is thought to be via an increase in neuronal glucose uptake leading to more acetyl-CoA being available for the production of Ach.

LA does not prevent plaque formation but it can re-solubilise existing plaques.

DHLA is a direct scavenger of reactive oxygen species but has no effect on other essential antioxidants.

Clinical study resultsThere is a large body of data on the efficacy of LA in AD.

LA 600 mg/day has been shown to slow the progression of dementia in a 4-year clinical trial.

At high concentrations LA removes both copper and iron from enzyme active sites.

Close last month's answers

Name: Address: Phone: Pharmaceutical Society Registration Number:

Which of the following answers are TRUE?
- Please tick (there may be more than one correct answer per question)

Obesity: a growing problemIn New Zealand, one in four adults are considered obese.

There is no difference between obesity and overweight in terms of mortality.

BMI can be effectively used as a sole measure of obesity.

Obesity: a complex diseaseEnvironmental factors are not considered to be a contributing factor in the development of obesity.

Bariatric surgery addresses the underlying causes of obesity.

A population health strategy should form an integral component of campaigns targeting obesity.

Increasing use of bariatric surgeryBariatric surgery is the only treatment able to maintain weight control in the majority of morbidly obese patients.

Reasonable attempts at weight loss with other strategies are one of the selection criteria for bariatric surgery.

Surgery can be considered as an initial treatment option for long-term weight loss.

Role of the pharmacistPatient counselling and reinforcement of lifestyle advice is a key component of the pharmacist’s role post bariatric surgery.

Drug absorption is unlikely to be altered by bariatric surgery.

Following bariatric surgery, other drug delivery routes may need to be considered.

Role of the pharmacistDumping syndrome is a rare adverse effect in gastric bypass patients.

In the post-operative period, pharmacists need to be aware of the potential for the serious nutritional complication of refeeding syndrome in patients that may be severely malnourished.

Medications used for the treatment of comorbid conditions that have improved or resolved after surgery can often be discontinued.

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