Obesity Flashcards

1
Q

Explain the calorie intake and uses of a VLED

A

Less than 800 calories a day.
Used for rapid weight loss and improved glycaemic control
For 8-12 weeks

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2
Q

Name a lipase inhibitor and it’s MOA

A

Orlistat. A pancreatic and gastric lipase inhibitor. Prevents the break down of fats, which prevents them from being absorbed.

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3
Q

How can you reduce the abdominal cramping and diarrhoea associated with orlistat use?

A

Reduce fat intake

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4
Q

Why is supplementation of oil soluble vitamins required when taking orlistat?

A

Because without fat you cannot absorb these vitamins from your diet (e.g. vitamin K)

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5
Q

Orlistat + anticoagulant precaution?

A

Since orlistat can reduce the absorption of vitamin K, can enhance effects of anticoagulants like warfarin

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6
Q

Define GLP1

A

Glucagon-like peptide 1. A hormone secreted when eating to promote the release of insulin from the pancreas + other effects

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7
Q

Other than stimulating insulin secretion, what effects does GLP1 have?

A

Decreases appetite, reduces gastric emptying and motility, increases energy expenditure and increases satiety

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8
Q

What is semaglutide?

A

A GLP-1 agonist.

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9
Q

Name 2 GLP-1 agonists

A

Liraglutide and semaglutide

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10
Q

How do GLP-1 agonists reduce appetite?

A

By slowing down gastric emptying

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11
Q

Compare dosing of liraglutide and semaglutide

A

Liraglutide is 3mg daily

Semaglutide is weekly

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12
Q

Explain the use of bulk forming agents like methylcellulose and fibre supplements in obesity

A

Peripherally acting. Not effective on their own but can be adjuvant. They promote bowel regularity rather than weight loss

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13
Q

Name 2 centrally acting appetite suppressants

A

Phentermine and lorcaserin

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14
Q

Phentermine MOA?

A

An amphetamine that acts directly on the satiety centre of the hypothalamus. Short term use only. Promotes the development of good eating behaviours

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15
Q

How does topiramate suppress appetite

A

It is an anti epileptic drug that inhibits glutamate release and increases dopamine. Used in kids who gained lots of weight due to atypical antipsychotics

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16
Q

What combination of drugs is in Contrave

A

Naltrexone and bupropion

17
Q

Explain the MOA of the naltrexone / bupropion

A

Naltrexone blocks feedback that typically promotes weight gain following weight loss. Also effects dopamine reward pathway and regulates appetite centre of hypothalamus

18
Q

Name some thermogenesis agents that can be used to combat a slow metabolic rate associated with hypothyroidism

A

Levothyroxine, caffeine, theophylline, ephedrine or pseudoephedrine