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Year II Pharmacolofy Term III > Obesity > Flashcards

Obesity Flashcards

1
Q

Most effective treatment for obesity

A

Bariatric surgery

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2
Q

Benefits of bariatric surgery

A

Weightloss maintained for up to 15 years

Imprvement of complication (DM2, HTN, dyslipidema & sleep apneal)

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3
Q

3 Requirements for antiobesity medications

A

decrease weight ≥ 5% in 12 months.
OR
35% of participants must lose > 5% (if double the
placebo and has achieved statistical significance).
Improve comorbidites

Weightloss from fat with low side effects

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4
Q

Name 5 FDA approved anti-obesity drugs

A 
Alli and Xenical
Qsymia
Belviq
Contrave
Saxenda
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5
Q

OB gene codes for

A

Leptin

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6
Q 
Leptin
Role
Expressed by?
Link to obesity
Short or long term signal
Acts at
A 
Supresses appetie & stimulates metabolis,
dipose tissue
Obese are insulin resistant
Long term signal
Pituatry
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7
Q

Name 4 short acting hormones hat reduce food intake prduced by GI tract/stomact

Regulated by

Act at

A 
Peptide tyrosinetyrosine
[PYY]
glucagon-like peptide 1 [GLP-1]
oxyntomodulin [OXM],
cholecystokinin [CCK]

Sympathetic/parasympathetic

Hyothalamus

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8
Q

Name 1 short acting appetite stimulating hormone produced by GI system

A

Ghrenlin

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9
Q

Name 3 appetie ihibition hormone produced by the pancrease

These act

A

pancreatic polypeptide [PP]
amylin
Insulin

Thalamus & hypothalamus

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10
Q

Requirements for anti-obesity medications

A 
Have a BMI ≥ 30 kg/m2
™ Have a BMI ≥ 27 kg/m2 and at least 1 concomitant
obesity-related risk factor or disease:
– Type 2 diabetes,
– heart disease,
– atherosclerosis,
– sleep apnea,
– excessive waist circumference,
– dyslipidemia,
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11
Q

Antiobesity medications should always be given with

A

Lifestyle changes (diet, exercise, counseling about realist changes in weight)

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12
Q

When do you discontinue obesity medications

A

After weight gain because effectiveness of therapy decreases over time

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13
Q

What is the best reponse and over how many months

A

0-15% total body weight lost over 12

months

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14
Q

Most effective drug

A

Qysmia

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15
Q 
Orlistat (Xenical OR Alli)
Mechanism
Benefits
SE
Why are there few SE
SE dependent on
Amount of weight loss
Must be supplemented with
A

Mechanism
- Inhibits gastric & pancreatic lipase

Benefits

  • Reduce LDL & total cholesterol
  • Reduce CV risk

SE
- Steatorrhea, fecal incontinence & frequent/urgent bowel movements

SE dependent on
- fat intake

Few SE
- Not absorbed

Amount of W loss
- 9-10 Kg

Supplemented with
- ADEK

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16
Q

Phentermine (Adipex-p)
Mechanism
Benefits
SE

A

Mechanism

  • Amphetamines
  • Appetite suppression by reducing neuropeptide Y and increase lepton
  • Release of dopamine & NE
  • Reuptake inhibition of catechoolmine by suprssion MAO

Benefits
- Monotherapy for 12 weeks

SE
- Elevated HR, BP, headace, dry mouth, insomnia, constiation, restlessness
Why are there few SE
SE dependent on
Amount of weight loss
Must be supplemented with
17
Q

(Qsymia, formerly Qnexa)
Contains

Mechanism

Dosing

SE

A

Contains
- Phentermine + Extended release topiramate

Mechanism
- Topiramate (blocks voltage dependent Na, GABA activity, antagonizes glutamate & carbon anhydrase enzymes)

Dosing
- Low, middle & full strength, start low and then increase if there in no weight loss in 2 weeks

SE
- Pregancy catogory X (1st triester)

18
Q 
Lorcaserin (Belviq)
Mechanism
SE
5HT-2A receptor cause
5HT-2B  receptor cause
A

Mechanism
- 5HT-2C serotonin receptor

SE
Headache
No impressive weightloss

5HT-2A: hallucinations
5HT-2B: Valvulopathy

19
Q

Contrave

Contains

A

Contains
- Bupropion + Naltrexone

Mechanism
- Reduces the pleasure of food

20
Q

Liraglutide (Saxenda)

Mechanisms (5)

SE/BB warning

Dosing

Cost

A

Mechanism

  • GLP-1 agonist (glucagon like peptide) which prevents the breakdown of peptidase DPP-IV
  • Improves action of insulin
  • Delays gastric emptying
  • CNS mediated appetite
  • Reduction in liver fat content

SE

  • Nausea & diarrhea but decreases with ongoing use
  • BBW throud C cell tumor
  • Very expensive
  • !injectiom
21
Q

Only obesity drug covered by medicaid

A

Liraglutide > Orlistat > Belviq

22
Q

Why is the lower dose of OTC orlistat not avaible OT

A

DUE TO TAMPERING CONCERN ALLI NOT CURRENTLY

AVAILABLE

23
Q

Drug that can be used as monotherapy and for how long

A

Phentermine

12 weeks

24
Q

Empatic

Contains

A

uproprion & zonisamide (anticonvulsant)

Year II Pharmacolofy Term III (6 decks)

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