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662 > Obesity > Flashcards

Obesity Flashcards

1
Q

What are the causes of obesity?

The fat computer programmer sit in his cubical all day chugging coconut milk. His boss is always yelling about deadlines. And sometimes his imaginary friend Pedro comes to visit showing him how to inject steroids with insulin needles. Genetically he is a preditor and shouts “Fuck The Oakleys”. To top it all of his gf isnt on contraceptives.

A
  • High calorie diet
  • No activity
  • Stress
  • Medications
    • Antipsychotics, Contraceptive, steroids, insulin, sulfonylureaus
  • Gentics
    • Prader-Willi, FTO gene
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2
Q

Obese class 1,2,3 BMI

A

30-34.9

35-39.9

> = 40

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3
Q

Management of obesity 1

A
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4
Q

Management of obesity 2

A
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5
Q

Diet to lose fat

A

Reduce calorie intake

500-100 kcal/day

goal 800-1200

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6
Q

Exercise

A

150 minutes

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7
Q

Behavior stuff?

A
  • Support group
  • Realistic goals
    • SMART/FITT
    • Shitty goal- I want to lose weight
    • SMART goal- eat 1500 calories per wk day and excercise for 30 minutes everyday loss 10 lbs
  • Self monitoring
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8
Q

Antiobesity Agents

Orlistat

DIs?

Vit K?

Take MVi 2 hours before or after

A

120 mg tid rx

>= 12

60 mg TID OTC

Seperate from levothyroxine by 1 hour

Monitor INR with vit K antagonist

reduces amiodarone efficacy

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9
Q

Lorcaserin

Dose

DI

AE

A

10 mg BID BMI > 30 BMI 27 with other comorbidities

Nausea headache, fatigue dizzy

Not to be used if pregnant, Valv HD, ESRD, caution in CHF, HTN, hyperprolactinemia

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10
Q

Phentermine/topiramate ER

A

Initial dose 3.75/23 mg for 14 days then 7.5/46 daily

may increase to 11.25/69 mg daily for 14 days

15/92 daily

Not to be used if pregnant, glaucoma, hyperthyroidism, MAOIs, suicide, moderate high CVD

Caution with renal or haptic impairment

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11
Q

Bupropion/naltrexone dosing

A

Wk1 - 1 tab am

2 1 tab bid

3 2 am 1 pm

4 2 tabs BID

Dont use in uncontrolled HTN, Seizure, bulimia, anorexia, prgnant

Caution in renal hepatic impairment

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12
Q

Liraglutide

A

Start with 0.6 mg SQ daily and increase by 0.6 weekly to dose of 3 mg

Lots of nausea,

No in thyroid cancer, pregnant, pancreatitis,

Renal

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13
Q

Dosing summary

A
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14
Q

When do you refer for bariatric surgery?

A

BMI >= 40 or 35 with additional comorbidiies

Very successful

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15
Q

Many types of bariatric surgery

A

Bands, Sleeve, bypass,

All reduce stomach volume

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16
Q

Patients that have gotten surgery should avoid?

A

ER drugs

need compounds or liquids

No NSAIDs

17
Q

____ Most common procedure?

A

RNYGB

need vitamins

18
Q

Exam questions

A
19
Q

Medication follow-up

A
20
Q

Medication discontinuation

A
21
Q

Surgery follow up

A
22
Q

When should Lorcaserin be used?

A

Patients with a BMI of > = 30 or BMI >= 27 with additional comorbidities

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