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pharmacy 358 > Eating disorders > Flashcards

Eating disorders Flashcards

1
Q

What is anorexia nervosa?

A

intense fear of gaining weight, significantly lower weight

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2
Q

What is bulimia nervosa?

A

recurrent episodes of binge eating then recurrent compensatory behaviour to prevent weight gain (vomit)

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3
Q

How long to get diagnosed with bulimia?

A

1x a week for 3 months

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4
Q

What is binge eating disorder?

A

binge eating with no compensatory behaviour (vomit)
MUST have 3 of :
eating rapidly
uncomfortably full
eatingg when not hungry
feeling guilty

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5
Q

IS AN or BN more connected to genetics?

A

AN

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6
Q

What does starvation do to the body?

A

increased cortisol causing HPA suppression which causes low hormones (amenorrhea and low libido
not a lot of tryptophan to make serotonin

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7
Q

What trigger most commonly causes HPA suppression?

A

stress

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8
Q

Which gender gets more eating disorders?

A

females

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9
Q

Which eating disorder has higher rates of mortality?

A

anorexia

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10
Q

What are the consequences from long term anorexia?

A

starvation, cardiac arrest, suicide

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11
Q

Do hospitalized pregnant women. or bulimic have higher heart attack risk?

A

bulimia

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12
Q

What mental disorder is common with eating disorders?

A

Anxiety, mood substance use

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13
Q

What is the general principle of treatment of eating disorders?

A

it is a coping mechanism so fix underlying and offer treatment for the symptoms

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14
Q

What happens if no estrogen?

A

osteoporosis, lowered growth, low libido, unexpected pregnancies

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15
Q

What event is a common relapse for eating disorders?

A

pregnancy

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16
Q

How can eating disorders effect pregnancy?

A

poor wight, miscarriage, nutrient deficiency, post partum depression

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17
Q

When will periods return?

A

in 6 months of achieving body weight of around 90%

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18
Q

What cardio complications can occur from AN?

A

prolonged QTc
Cardiac atrophy
bradycardia
arrhythmia
hypotension

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19
Q

At what QTc are you at risk of TDP?

A

> 470

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20
Q

What causes the arrhythmia in AN?

A

Low K

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21
Q

Will cardiac issues resolve?

A

with weight restoration yes
BUT
irreversible myocarditis with emetine toxicity

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22
Q

What does chronic ipecac use do?

A

induces vomitting
irreversible myocarditis

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23
Q

How can we lower refeeding risk?

A

refeed slow
phosphorus supplement
hospital

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24
Q

How can we treat gastroparesis?

A

Domperidone and metoclopramide

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25
Q

Why is domperidone better than metoclopramide?

A

doesn’t cross BBB= no EPS

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26
Q

Risks of domperidone?

A

QTc prolonging

27
Q

How does domperidone work?

A

peripheral dopamine antagonist

28
Q

What can we do for constipation?

A

Peg to retrain
if need bowel taper use sennosides

29
Q

Any risk with sennosides?

A

be abused to Lose weight

30
Q

What would show dehydration in eating disorders?

A

high BUN

31
Q

What effects on liver does eating disorders cause?

A

low albumin, high high INR, LFT increase

32
Q

Would you have metabolic acidosis or alkalosis if vomiting?

A

Alkalosis

33
Q

Would you have metabolic acidosis or alkalosis if abusing laxative?

A

acidosis

34
Q

When is most bone built?

A

adolescent

35
Q

Which eating disorder has highest risk of OP?

A

AN

36
Q

Does estrogen replacement help with bones?

A

NOPE
does not increase BMD

37
Q

Do calcium and vitamin d supplementation help?

A

probably
Calcium 1200-1500mg and Vitamin D 1000 IU/day

38
Q

Do bisphosphanates work?

A

no in teenagers
no studies for adults but can extrapolate

39
Q

What is the best way to recover BMD?

A

weight recovery duh

40
Q

How long does it take BMD to increase after restoring weight?

A

1-2 years

41
Q

Is BMD always recoverable?

A

FU no

42
Q

How to begin refeeding?

A

30-40kcal/kg/day then to 70-100

43
Q

Which is better IV or NG to feed?

A

NG

44
Q

What electrolytes must we monitor when feeding?

A

PO4, MG, K, NA, Ca daily for first 5 days

45
Q

What is refeeding syndrome?

A

bloating, nausea, electrolytes rush into cells, retains fluid which causes more work for the heart, and this is bad

46
Q

What electrolyte is crucial for the function of the heart?

A

PO4 as this is used in ATP

47
Q

Non pharm for AN?

A

CBT

48
Q

What is zinc used for?

A

zinc deficiency exhibit similar to AN

49
Q

Does zinc help with BMI resting?

A

oof who knows perhaps??

50
Q

Do antipsychotics help in AN?

A

only olanzapine showed weight increase BUT not benefit on eating disorder mentally

51
Q

Risks with antipsychotics?

A

EPS, QTc, tardive

52
Q

DO TCA help?

A

no

53
Q

Do SSRI help?

A

help with comorbid conditions AFTER weight is restored

54
Q

Does bupropion help?

A

NO, seizure risk

55
Q

What are signs of bulimia?

A

dental caries, esophagus damage, parotid gland enlargement

56
Q

What is usually the weight of a bulimic person?

A

upper end of normal or slightly overweight

57
Q

Best psychotherapy for bulimia?

A

CBT

58
Q

Is CBT better than drugs for bulimia?

A

OBV

59
Q

AT what % weight does menses restart?

A

90% of normal

60
Q

What drugs are good for bulimia?

A

SSRI- lower binge-purge episodes

61
Q

Do you need to have depression in order to use SSRI’s for bulimia?

A

NO.
Benefit regardless

62
Q

What SSRIs are good for bulimia and which has the indication?

A

FLUOXETINE-indication
citalopram
sertraline

63
Q

Does topiramate help with bulimia?

A

it does decrease episodes BUT
side effects brutal- brain fog

pharmacy 358 (16 decks)

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