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Pharm 1 > obesity > Flashcards

obesity Flashcards

1
Q

obese waist circumference for M and F

A

M: >40 in

F >35 in

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2
Q

normal BMI range

A

18.5-24.9

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3
Q

obese 1 BMI

A

30-34.9

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4
Q

indication for bariatric surgery w/o comorbities

A

BMI>40

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5
Q

co moribities that allow for bariatric surgery for BMI 30-34.9

A

uncontrollable T2DM, metabolic syndrome

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6
Q

how to avoid dumping syndrome post -gastric bypass

A

avoid simple carbs

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7
Q

indications for pharm treatment of obesity

A

> 3-6 months of behavior therapy, dietary chagnes, and increased activity AND BMI>30 or >27 w/ other risk factors

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8
Q

Phentermine (Adipex-P), Diethylpropion (Tenuate), Phentermine/Topiramate ER (Qsymia)

A

Sympathomimetics

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9
Q

Orlistat (Xenical-Rx) or (Alli-OTC)

A

Gastrointestinal lipase inhibitor

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10
Q

Bupropion/naltrexone (Contrave)

A

Combination of antidepressant + opioid antagonist

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11
Q

Liraglutide (Saxenda), semaglutide (Trulicity)

A

Glucagon-like peptide-1 (GLP-1) agonist

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12
Q

Adverse effects:
Cardiovascular: HTN, pulmonary hypertension, tachycardia
CNS: psychosis, seizures, tremor euphoria, drug dependency and addiction

A

Sympathomimetics

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13
Q

Sympathomimetics contraindications

A

Avoid in patients w/ history of drug abuse
Pulmonary hypertension, severe atherosclerosis, uncontrolled HTN, glaucoma, hyperthyroidism,pregnancy, breast feeding, CAD, stroke,CHF
Use of an MAOI in the last 14 days

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14
Q

Drug Interactions:Avoid use with SSRIs or TCAs as risk of serotonin syndrome could occur

A

Sympathomimetics

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15
Q

Pt counseling for Sympathomimetics

A

monitor HR and BP several times / wk at different times

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16
Q

Sympathomimetics increase what catacholamine

A

NE

17
Q

Pt counseling for phentermine/topiramate (Qsymia)

A

cousnel F on risk of birth defects (oral clefts if during 1st trimester)

18
Q

SE: dry mouth, altered taste, paresthesia, constipation,dizziness, sedation

A

topamax

19
Q

dose considerations w/ topamax

A

Titrate OFF Qsymia or Topamax gradually as withdrawal from topiramate can cause seizure

20
Q

MOA: Pancreatic and gastric lipase inhibitor; inhibits triglyceride hydrolysis; blocks the absorption of ingested fat

A

Orlistat (Xenical Rx) and (Alli OTC)

21
Q

Pt counseling for orlistat

A

Must take within 1 hour of consuming high fat meal. low fat diet. supplement w/ fat soluble vitamins. back up BC if diarrhea

22
Q

orlistat can improve which biomarkers

A

decrease LDL and improve glucose control

23
Q

SE: Flatulence w/ discharge, oily or loose stool, fecal urgency/incontinence, and steatorrhea. Reduced absorption of fat-soluble vitamins (A,D,E,K) with a potential for malnutrition; reduced absorption of oral contraceptives and other drugs. hepatoxicity

Minimized by maintaining a strict low fat diet (<30% of diet)

A

orlistat

24
Q

Adverse effects: suicidal ideation and seizures (bupropion), Nausea!/V, headache, constipation, dizziness, ↑ BP/HR, and dry mouth

A

Bupropion/naltrexone (Contrave)

25
Q

drug interactions for Bupropion/naltrexone (Contrave)

A

alcohol (bupropion), opioids (naltrexone)

26
Q

contraindications for Bupropion/naltrexone (Contrave)

A

pregnancy; seizure disorder; uncontrolled HTN; chronic opioid use (naltrexone), eating disorder

27
Q

how to minimise nausea from Bupropion/naltrexone (Contrave)

A

titrate dose up slowly

28
Q

Adverse effects: GI upset, tachycardia, headache, hypoglycemia, acute pancreatitis, acute gallbladder disease; thyroid C-cell hyperplasia, suicidal behavior

A

Liraglutide (Saxenda), semaglutide (Trulicity)

29
Q

contras for Liraglutide (Saxenda), semaglutide (Trulicity)

A

pregnancy; personal or family history of thyroid carcinoma

30
Q

how do Glucagon-like peptide-1 agonists affect oral meds?

A

Decrease gastric emptying which may decrease the absorption of oral medications

31
Q

Approved by the FDA as a weight loss “device”, not a drug
Hydrogel
Orally administered before meals
Not systemically absorbed
Mechanism: expands in the stomach and intestine to create a sensation of satiety
Eliminated through feces

A

Plenity

Pharm 1 (17 decks)

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