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DT4- Exam 2 > Goebel- Obesity-Leah > Flashcards

Goebel- Obesity-Leah Flashcards

1
Q

Criteria to be weight loss MED candidiate?

SURGERY candidiate?

A

Med: BMI over 30 or 27 + comobidities
Surg: BMI over 40 or 35 + comorbidities

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2
Q

What do the drugs PHENtermine, diethylPropion, and PHENdimetrazine have in common?

A
  • Supress appetite by releasing NE

- not to be used in HTN or CVD

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3
Q

What weight loss medication is the most expensive and must be INJECTED?
What is its MOA?
One scary ADR? One black box ADR?

A
  • Liraglutide
  • GLP1 receptor agonost
  • colon cancer
  • BBW: thyroid cancer
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4
Q

What weight loss medication is FDA approved AND can be purchased OTC?
What is it’s MOA?
One scary ADR?

A
  • Orlistat
  • pancreatic lipase inhibitor
  • liver impairment –> death
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5
Q

LorcaSERin MOA?

3 key ADRs?

A
  • 5HT2c agonist = ^^ SERotonin

- serotonin storm, NMS, valve disease

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6
Q

Phentermine/ topiramate MOA?
Strange ADR?
One thing you should counsel your patients about?
Not for use in?

A
  • ^^ NE AND GABA
  • dysgeusia
  • counsel about possibility of ^^ suicidal thoughts
  • not in HTN, CVD
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7
Q

Naltrexone/ bupropion MOA?
Black box warning?
Not for use in?

A
  • opioid antagonist
  • ^^ DOPA/ NE
  • BBW: suicide
  • not in CVD
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8
Q

Two drugs to avoid in depressed patients?

A

both COMBO drugs
(phentermine/topiramate; naltrexone/bupropion)
-phentermine ^^ suicidal ideation and suicide is BBW for naltrexone/ bupropion

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9
Q

Drug that might be best for a patient with morbid obesity, HTN, AND diabetes?

A

-Liraglutide

B/c can treat the obesity AND DM

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10
Q 
What do:
Caralluma fimbriata 
Hydroxycut 
Garcinia Cambogia 
Have in common?
A

-THEY. DON’T. WORK.

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11
Q

Severe ADR assc with hydroxycut?

A

SEVERE HEPATOTOX!

This can still be purchased!!

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12
Q

What is considered effective weight loss?

A

most than 5% body weight loss over 3 months

discontinue meds if this is not attained because risks are ooutweighing benefits

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13
Q

To obtain 1-2 pound/week weight loss, what dietary change should be made?

A

Reduce daily food intake by 500 kcal

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14
Q

Realistic weight loss goal regardless of total weight?

Ideal weight loss calories for males? females?

A
  • 10% body weight or 1-2 pounds per week
  • females: 1200-1500
  • males: 1500-1800
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15
Q

Diet style assc with slightly higher mortality than others?

A

-High protein (1.04x)

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16
Q

Four types of weight loss surgeries?
Which has both the highest success rate and highest complication rate?
highest DEATH rate?
lowest complication rate?

A
  • Biliary diversion + duodenal switch
  • Roux en Y
  • Vertical sleeve
  • Gastric banding

Biliary diversion: highest success rate BUT highest complication rate
Roux en Y: 1.94% death rate!
Lowest complication: vertical sleeve

17
Q

Surgical weight loss procedure assc with dumping syndrome?

Diarrhea and foul smelling gas?

A
  • dumping: Roux en Y

- diarrhea: Biliary diversion

18
Q

How to decrease the complication rate of any bypass procedure?

A

-Go to high volume hospital
(more than 100 cases/ year)
-Esp important in older patients

19
Q

Most expensive weight loss surgery?

Cheapest?

A
  • most expensive: biliary diversion/duodenal switch

- cheapast: lap band

20
Q

What is “orbera”?

A
  • essentially a balloon shoved into your stomach via endoscopy
  • removed early super often due to complication
21
Q

What is a vbloc maestro?

Who is a candidaite?

A
  • Vagus nerve block to reduce hunger

- same criteria as sx

22
Q

Whats an endobarrier?

Whos a candidate?

A
  • plastic device lines the intestine to prevent absorption

- NO ONE in the US is a candidiate. It isn’t approved

23
Q

Exercise plan for weight loss?

Pedometer goal?

A
  • At least 30 mins/day, 225 mins/ week
  • Type of exercise (aerobic + aerobic and weight training combo) not important. Just exercise.
  • 8k-10k steps
24
Q

Qsymia is the same as? Contrave is the same as?

NEITHER of these drugs should be used in?

A

Qsymia: Phentermine/ topiramtate
Contrave: naltrexone/ buproprion

Not in depression OR HTN!!!!!!

(I know we don’t normally learn brand names but Qsymia is in a practice question.)

DT4- Exam 2 (12 decks)

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