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NAPLEX 2023 > Chapter 57: Weight loss > Flashcards

Chapter 57: Weight loss Flashcards

1
Q

BMI for an overweight person

A

25-29.9 kg/m2

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2
Q

BMI for an obese person

A

≥ 30 kg/m2

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3
Q

Key drugs/conditions that can cause weight gain

A
  • Antipsychotics (e.g., clozapine, olanzapine, risperidone, quetiapine)
  • Diabetes drugs (insulin, meglitinides, SU, TZDs)
  • Divalproex/valproic acid
  • Gabapentin, pregabalin
  • Lithium
  • Mirtazapine
  • Steroids
  • TCAs (e.g., amitriptyline, nortriptyline)
  • Conditions: hypothyroidism
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4
Q

Physical activity should increase to ≥ ___ minutes per week, performed on __-__ separate days

A

150 minutes

3-5 days

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5
Q

OTC weight loss supplements commonly contain stimulants, such as

A

bitter orange and/or excessive amounts of caffeine

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6
Q

What other names can caffeine be packaged under

A

Guarana and concentrated green tea powder

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7
Q

When are prescription weight loss meds indicated

A

BMI ≥30 kg/m2 or a BMI ≥ 27 kg/m2 with at least one weight-related condition (such as dyslipidemia, HTN or diabetes)

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8
Q

Weight loss meds are only used in addition to

A

a dietary plan and increased physical activity

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9
Q

Which newer agents for weight loss can be continued long-term for weight maintenance

A

Qsymia, Contrave, Saxenda and the orlistat formulations

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10
Q

When should weightloss drugs be d/c

A

if they do not produce at least a 5% weight loss at 12 weeks

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11
Q

Key drugs/conditions that can cause weight loss

A
  • ADHD drugs (e.g., amphetamine, methylphenidate)
  • Bupropion
  • GLP-1 agonists (e.g., exenatide, liraglutide)
  • Pramlintide
  • Roflumilast
  • SGLT2 inhibitors (e.g., canagliflozin, empagliflozin)
  • Topiramate
  • Conditions: hyperthyroidism, celiac disease, inflammatory bowel disease
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12
Q

Which weight loss drugs can be used in pregnancy

A

NONE - AVOID

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13
Q

Which weight loss drugs should be avoided in HTN

A

Contrave - CI with uncontrolled BP (contains bupropion)

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14
Q

Which weight loss drugs should be used with caution in HTN

A

Qsymia - monitor HR (contains phentermine)

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15
Q

Which weight loss drugs should be used with caution in young adults and adolescents with depression

A

Contrave - suicide risk (contains bupropion)

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16
Q

Which weight loss drugs should be avoided in seizures

A

Contrave - lowers seizure threshold (contains bupropion)

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17
Q

Which weight loss drugs should be used with caution in seizures

A

Qsymia - must taper off slowly if used (contains topiramate)

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18
Q

Which weight loss drugs should be avoided if taking opioids

A

Contrave - blocks opioid receptor (contains naltrexone)

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19
Q

Phentermine drug class

A

Sympathomimetic (stimulant)

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20
Q

Which medications are found in Qsymia

A

Phentermine and topiramate ER

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21
Q

Which medications are found in Contrave

A

Naltrexone and bupropion

22
Q

What do the components of Contrave do for weight loss

A

naltrexone: decreases food cravings
bupropion: decreases appetite

23
Q

Which weight loss drug has a REMS progrm

A

Qsymia

due to teratogenic risk

24
Q

Qsymia contraindications

A

pregnacy, glaucoma

25
Q

Qsymia SE

A

Tachycardia, CNS effects (i.e, insomnia)

26
Q

Contrave contraindications

A

pregnancy, chronic opioid use, uncontrolled HTN, seizure disorder, other-bupropion containing products, MAO inhibitors within past 14 days

27
Q

GLP-1 receptor agonist mechanism for weight loss

A

increases satiety

28
Q

Liraglutide brand name for weight loss

A

Saxenda

29
Q

Saxenda warnings

A

pancreatitis, hypoglycemia

30
Q

Saxenda contraindications

A

pregnancy

31
Q

Saxenda SE

A

nausea

32
Q

Which weight loss drug is a lipase inhibitor

A

Orlistat

33
Q

Orlistat rx name

A

Xenical

34
Q

Orlistat OTC name

A

Alli

35
Q

Orlistat MOA

A

decreases absorption of dietary fats by ~30%

36
Q

Orlistat must be used with

A

a low-fat diet plan

37
Q

Orlistat SE

A

GI (flatus with discharge, fatty stool)

38
Q

What must be taken with Orlistat

A

Multivitamin A, D, E & K and beta carotene at bedtime or separated by ≥ 2 hrs

39
Q

What is the max % of kcals from fat that can be taken with Orlistat

A

30%

40
Q

orlistat contraindication

A

pregnancy

41
Q

Phentermine brand name

A

Adipex-P

42
Q

Phentermine CI

A

CV disease (e.g., uncontrolled HTN), hyperthyroidism, glaucoma, pregnancy, hx of drug abuse

43
Q

Phentermine SE

A

Tachycardia, agitation, increased BP

44
Q

Phentermine monitoring

A

HR, BP

45
Q

How long can phentermine be used for

A

short-term up to 12 weeks to “jump-start” a diet

46
Q

Guidelines recommend weight loss or bariatric surgery for adults when BMI ≥ ___ kg/m2 or when BMI ≥ __ kg/m2 with an obesity-related condition

A

40
35

47
Q

Which calcium supplement is preferred for bariatric surgery and why

A

calcium citrate since it has non-acid dependent absorption

48
Q

Anemia can present from which vitamin deficiencies

A

B12 and iron

49
Q

Iron & Ca supplements should be taken how many hrs prior or how many hours after antacids

A

2 hrs prior and 4 hrs after

50
Q

Medications may require dose reduction, and may need to be crushed and put in liquid or used in transdermal form for up to ____ months post-surgery

A

2

51
Q

Which medication can be used to dissolve gallstones after rapid weight loss

A

Ursodiol

NAPLEX 2023 (88 decks)

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