module 16 weight management

Question 1

to know if weight loss drugs work

Answer 1

produce 5% weight loss compared to placebo

- most pt lose 5-10% of body wt

Question 2

candidate for weight loss medication

Answer 2

BMI > 30

BMI > 27 with at least 2 comorbidities

Question 3

anorexiants: appetite suppression med

Answer 3

phentermine

Question 4

phentermine MOA

Answer 4

inc. NE and DA release and inhibit reuptake

- > fight or flight response and dec. appetite

Question 5

phentermine AE

Answer 5

avoid abrupt withdrawal
inc. HR
HTN
insomnia
dizzy
HA
tremor
restlessness
xerostomia
impotence/libido changes
diarrhea 
constipation

Question 6

phentermine CI

Answer 6

MAOI w/in 14 days: HTN 
pregnancy/breastfeeding
Hx CV disease
uncontrolled HTN
hyperthyroidism 
glaucoma
drug misuse 
caution: 
- elderly
- HTN
- DM
- renal impaired

Question 7

phentermine admin

Answer 7

renally eliminated

ST use: 3-4mo

Question 8

phentermine EDU

Answer 8

tolerance to wt. loss in a few weeks

schedule IV drug

Question 9

phentermine monitoring

Answer 9

Preg: need to be on birth control
BP
HR
EKG

Question 10

lipase inhibitor med

Answer 10

orlistat

Question 11

orlistat MOA

Answer 11

pentanoic acid ester inhibits gastric and pancreatic lipases

• > no fat breakdown/absorption
• fat stays in intestine

Question 12

orlistat use

Answer 12

wt. loss/ management

Question 13

orlistat AE

Answer 13

oily spotting
flatulence with discharge
fecal urgency
inc. defecation 
rare: pancreatitis, liver inj

Question 14

orlistat admin

Answer 14

admin with meals that contain fat
- inhibits fat absorption by 30%
minimal systemic absorption
- fecal elimination

Question 15

orlistat CI

Answer 15

pregnancy
chronic malabsorption
cholestasis

Question 16

orlistat EDU

Answer 16

take multivitamin daily

minimize AE w/ low-fat diet or cholestyramine admin

Question 17

orlistat DI

Answer 17

interferes with absortion of fat soluble vitamins: A,D,E,K, beta-carotene
levothyroxine: admin 4 hours apart