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PHRM 825 > Exam 1: Obesity and Overweight Treatment > Flashcards

Exam 1: Obesity and Overweight Treatment Flashcards

1
Q

What medical conditions are associated with causing weight gain?

A

Depression
Growth Hormone Deficiency
Cushing Syndrome
Polycystic Ovary Syndrome

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2
Q

What drug classes are associated with causing weight gain?

A 
Anticonvulsants 
Antidepressants
Atypical Antipsychotics
Conventional Antipsychotics 
Hormones
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3
Q

What are the goals of weight loss?

A

Reduction in body weight (5-10% in 6 months)
Maintain body weight
Prevent weight gain
Improve obesity related conditions

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4
Q

What are the indications for weight loss surgery?

A

BMI 40+
BMI 35+ with no response to behavioral treatment with or without pharmacotherapy with coexisting conditions and motivated to lose weight

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5
Q

What are the indications for prescription drug weight loss therapy?

A

BMI 35+ OR BMI 27+ with risk factors and did not lose/maintain weight loss with comprehensive lifestyle intervention

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6
Q

What are the five drugs approved by the FDA for chronic weight loss?

A 
Orlistat (Xenical, Alli)
Lorcaserin (Belviq)
Phentermine/Topiramate ER (Qysmia)
Naltrexone/bupropion ER (Contrave)
Liraglutide (Saxenda)
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7
Q

What is the MOA for Orlistat?

A

Inhibits gastric and pancreatic lipases to decrease absorption of dietary fats by 30%.

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8
Q

What is the only FDA approved weight loss therapy for adolescents (12+)

A

Xenical (Prescription Orlistat)

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9
Q

What is the dosing for Xenical?

A

120 mg PO tid within 1 hour of eating a fat containing meal. If the meal does not contain fat, forego the dose.

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10
Q

What is the dosing for Alli?

A

60 mg PO tid within 1 hour of eating a fat containing meal.

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11
Q

What is a counseling tip for patients taking orlistat?

A

Take a multivitamin

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12
Q

What are the contraindications for orlistat?

A

Pregnancy, chronic malabsorption syndrome, cholestasis

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13
Q

What is the brand name for lorcaserin?

A

Belviq

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14
Q

What is the MOA for Belviq?

A

Activates serotonin 5-HT2c receptors in the hypothalamus. Results in satiety and decreased food intake.

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15
Q

What is the dosing for Belviq?

A

10 mg PO bid with or without food

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16
Q

What is the dosing for Belviq ER?

A

20 mg PO d with or without food

17
Q

Should patients with severe ESRD take Belviq?

A

No

18
Q

What is the average weight loss for orlistat?

A

2.9-3.4 kg

19
Q

What is the average weight loss for Belviq?

A

3.6 kg

20
Q

What two weight loss therapies are C-IV?

A

Belviq and Qsymia. Qysmia must be distributed by a REMS pharmacy.

21
Q

What are the contraindications for Belviq?

A

Pregnancy and lactating women

22
Q

What is the brand for phentermine/Topiramate ER?

A

Qsymia

23
Q

What is the MOA for Qsymia?

A

Stimulate release of norepinephrine to reduce appetite and enhance satiety with carbonic anhydrase inhibitor.

24
Q

What is the dosing for Qsymia?

A 
3.75/23 mg PO daily
14 days later...
7.5/46 mg PO daily
12 weeks later...
assess weight loss, if 3+% lost continue, if not d/c or increase to 11.25/69 mg PO daily 
14 days later....
15/92 mg PO daily
assess weight loss, if <5% gradually discontinue by taking every other day
25
Q

What is the average weight loss experienced with Qsymia?

A

6.6-8.6 kg

26
Q

What is a counseling tip for Qsymia?

A

Take in the am to avoid insomnia

27
Q

What is a big contraindication for Qsymia?

A

Teratogen

28
Q

What is the brand name for Naltrexone/bupropion ER?

A

Contrave

29
Q

What is the MOA for Contrave?

A

Opioid that may decrease food cravings and suppress appetite.

30
Q

What is the dosing for Contrave?

A

week 1: 1 tab in am
week 2: 1 tab in am 1 tab in pm
week 3: 2 tab in am 1 tab in pm
week 4: 2 tab in am 2 tab in pm

If 5% not achieved after highest dose, discontinue

31
Q

What is the average weight loss associated with Contrave?

A

4.9 kg

PHRM 825 (1 decks)

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