Goebel- Obesity-Leah Flashcards
Criteria to be weight loss MED candidiate?
SURGERY candidiate?
Med: BMI over 30 or 27 + comobidities
Surg: BMI over 40 or 35 + comorbidities
What do the drugs PHENtermine, diethylPropion, and PHENdimetrazine have in common?
- Supress appetite by releasing NE
- not to be used in HTN or CVD
What weight loss medication is the most expensive and must be INJECTED?
What is its MOA?
One scary ADR? One black box ADR?
- Liraglutide
- GLP1 receptor agonost
- colon cancer
- BBW: thyroid cancer
What weight loss medication is FDA approved AND can be purchased OTC?
What is it’s MOA?
One scary ADR?
- Orlistat
- pancreatic lipase inhibitor
- liver impairment –> death
LorcaSERin MOA?
3 key ADRs?
- 5HT2c agonist = ^^ SERotonin
- serotonin storm, NMS, valve disease
Phentermine/ topiramate MOA?
Strange ADR?
One thing you should counsel your patients about?
Not for use in?
- ^^ NE AND GABA
- dysgeusia
- counsel about possibility of ^^ suicidal thoughts
- not in HTN, CVD
Naltrexone/ bupropion MOA?
Black box warning?
Not for use in?
- opioid antagonist
- ^^ DOPA/ NE
- BBW: suicide
- not in CVD
Two drugs to avoid in depressed patients?
both COMBO drugs
(phentermine/topiramate; naltrexone/bupropion)
-phentermine ^^ suicidal ideation and suicide is BBW for naltrexone/ bupropion
Drug that might be best for a patient with morbid obesity, HTN, AND diabetes?
-Liraglutide
B/c can treat the obesity AND DM
What do: Caralluma fimbriata Hydroxycut Garcinia Cambogia Have in common?
-THEY. DON’T. WORK.
Severe ADR assc with hydroxycut?
SEVERE HEPATOTOX!
This can still be purchased!!
What is considered effective weight loss?
most than 5% body weight loss over 3 months
discontinue meds if this is not attained because risks are ooutweighing benefits
To obtain 1-2 pound/week weight loss, what dietary change should be made?
Reduce daily food intake by 500 kcal
Realistic weight loss goal regardless of total weight?
Ideal weight loss calories for males? females?
- 10% body weight or 1-2 pounds per week
- females: 1200-1500
- males: 1500-1800
Diet style assc with slightly higher mortality than others?
-High protein (1.04x)
Four types of weight loss surgeries?
Which has both the highest success rate and highest complication rate?
highest DEATH rate?
lowest complication rate?
- 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
Surgical weight loss procedure assc with dumping syndrome?
Diarrhea and foul smelling gas?
- dumping: Roux en Y
- diarrhea: Biliary diversion
How to decrease the complication rate of any bypass procedure?
-Go to high volume hospital
(more than 100 cases/ year)
-Esp important in older patients
Most expensive weight loss surgery?
Cheapest?
- most expensive: biliary diversion/duodenal switch
- cheapast: lap band
What is “orbera”?
- essentially a balloon shoved into your stomach via endoscopy
- removed early super often due to complication
What is a vbloc maestro?
Who is a candidaite?
- Vagus nerve block to reduce hunger
- same criteria as sx
Whats an endobarrier?
Whos a candidate?
- plastic device lines the intestine to prevent absorption
- NO ONE in the US is a candidiate. It isn’t approved
Exercise plan for weight loss?
Pedometer goal?
- At least 30 mins/day, 225 mins/ week
- Type of exercise (aerobic + aerobic and weight training combo) not important. Just exercise.
- 8k-10k steps
Qsymia is the same as? Contrave is the same as?
NEITHER of these drugs should be used in?
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.)
