lecture 64 Flashcards
ott - pharmacotherapy of eating disorders
how is AN defined in the DSM-5?
restriction of energy intake leading to a significantly low body weight
intense fear of gaining weight or becoming fat
what other psychiatric disorders are common in ppl with AN?
depression
OCD
suicidal ideation
what are the types of AN?
restricting type
binge-eating/purging type
what BMI is considered to be the low end of normal?
18.5 kg/m2
what are health consequences associated with AN?
abnormally slow HR, low BP
decreased bone density
weakness
electrolyte abnormalities
hypoglycemia
dry skin, hair loss
severe dehydration
downy layer of hair (lanugo) all over body
cold intolerance
delayed gastric emptying
constipation
what are the two types of treatment for AN?
inpatient – treatment of acute risk
outpatient – treatment of chronic symptoms and relapse prevention
when does re-feeding syndrome occur?
when there is a shift from fat metabolism to glucose metabolism
what symptoms arise out of re-feeding syndrome?
hypokalemia, water retention, and severe edema
which can lead to multiple organ failures
how should AN be treated in general?
increase calories slowly
use CBT (best outcomes)
CI use of bupropion
how is binge eating disorder defined in the DSM-5?
recurrent episodes of binge eating
at least 1/week for 3 months
not associated with the recurrent use of inappropriate compensatory behavior
how is the number of episodes specified in binge-eating disorders?
mild –> 1 to 3
mod –> 4 to 7
severe –> 8 to 13
extreme –> over 14
PER WEEK
what are the health consequences of BED?
similar to what is observed in obesity
HTN, elevated cholesterol, CVD, T2DM, Gallbladder disease
how is BED treated?
CBT + medication provides best outcomes
Vyvanse is the best FDA-approved option, but may topiramate
how is bulimia nervosa defined in the DSM-5?
recurrent episodes of binge with recurrent inappropriate compensatory behaviors
at least once per week for 3 months
how are the episodes of BN categorized?
same as BED
what are the health consequences of BN?
recurrent bingeing and purging can affect the entire digestive tract including inflammation, gastric rupture, and esophageal rupture from frequent vomiting (mallory weiss tears)
chronic irregular BM and C as a result of laxative missue
what can happen to a person with T1DM and BN?
DKA from withholding insulin
what are the different methods of purging?
vomiting
laxatives
diuretics
excessive exercise
diabulimia (T1DM pts)
how is BN treated?
CBT and fluoxetine
