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GI > Obesity management > Flashcards

Obesity management Flashcards

1
Q

What is considered a high risk waist circumference?

A

men >40in
women >35in

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2
Q

What BMI range should waist circumference be measured?

A

25-34.9

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3
Q

What are people at a normal weight with a high risk waist circumference at increased risk for?

A

Cardiovascular diseases
HTN
T2DM

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4
Q

When should weight loss medications be considered in addition to lifestyle modifications?

A

> /= 30

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5
Q

How much of a calorie deficit is needed to lose 1 lb a week?

A

500 kcal/ day

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6
Q

What should be used in conjunction with diet?

A

physical activity

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7
Q

What is the standard recommendation for moderate-intensity physical activity per day?

A

30 min on 5 or more days of the week

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8
Q

What is the MOA of Phentermine (ADIPEX-P)?

A

sympathomimetic amine –> stimulates release of NE –> decreases hunger

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9
Q

How long should Phentermine be used for?

A

short-term; no more than 12 weeks

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10
Q

What are SEs with Phentermine?

A
  1. increased HR and BP
  2. restlessness/ insomnia
  3. headache
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11
Q

What are CIs to Phentermine?

A
  1. CVD
  2. coronary artery disease
  3. arrhythmias
  4. stroke
  5. congestive HF
  6. glaucoma
  7. seizures
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12
Q

What is the MOA of Orlistat?

A

gastrointestinal lipase inhibitor; blocks absorption of ~1/3 of dietary fat from the GI tract

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13
Q

What are the 2 brand names for Orlistat?

A

Rx: XENICAL
OTC: ALLI

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14
Q

What are SEs to Orlistat?

A
  1. gas
  2. oliy spotting
  3. oily/ fatty stool
  4. fecal incontinence, urgency, frequency
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15
Q

How are SEs with Orlistat managed?

A

adhering to low-fat diet that contains an average of 15g / meal

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16
Q

What are important patient counseling points for Orlistat?

A
  1. multivitamin containing ADEK taken > 2h before, after Orlistat, or at bedtime
  2. separate Orlistat and levothyroxine by 4 hours
  3. INR may increase when taking warfarin
17
Q

What is the MOA of Phentermine/ Topiramate (QSYMIA)?

A

Topiramate: unknown nut appears to suppress appetite and enhance satiety

18
Q

How must Qsymia be dosed?

A

start treatment with 3.75mg/ 23mg QD x 14 days then increase the dose slowly

19
Q

Why should Qsymia be taken in the morning?

A

insomnia

20
Q

What are CIs to Qsymia?

A
  1. pregnancy (birth defects)
  2. glaucoma
  3. hyperthyroidism
21
Q

What is the MOA of Naltrexone/ Bupropion ER (CONTRAVE)?

A

affects the hypothalamus and mesolimbic dopamine circuit involved in regulation of food intake

22
Q

What is the dosing schedule for Contrave?

A

Week 1: 1 tab qam
Week 2: 1 tab qam and 1 tab 2pm
Week 3: 2 tabs qam and 1 tab qpm
Week 4 and beyond: 2 tabs qam and 2 tabs qpm

23
Q

What are the BBWs for contrave?

A

Suicidality
Neuropsychiatric events

24
Q

What are CIs to Contrave?

A
  1. seizure disorders
  2. anorexia/bulimia
  3. abrupt D/C of alcohol, benzos, barbs, or antiepileptic drugs
  4. use of other bupropion products
  5. chronic opioid use (none in the last 7-10 days)
25
Q

What are warnings for contrave?

A
  1. should not be taken with high-fat meals
  2. risk of hepatotoxicity
26
Q

What is the MOA of Liraglutide (SAXENDA)?

A

GLP-1 receptor agonist; regulates appetite and calorie intake

27
Q

How is SAXENDA administered?

A

SQ in abdomen, thigh, upper arm

28
Q

How is saxenda dose increased?

A

4 week dosage escalation to minmize GI symptoms; max 3.0mg/day

29
Q

What are common SEs with SAXENDA, WEGOVY, and ZEPBOUND?

A
  1. N/V/D
  2. constipation
  3. dyspepsia
  4. abdominal pain
30
Q

What are CIs with saxenda, Wegovy, and Zepbound?

A

personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2

31
Q

What BBW does Saxenda and Wegovy have?

A

risk of thyroid C-cell tumors , including medullary thyroid carcinoma

32
Q

What are warnings with Saxenda?

A

acute pancreatitis
acute gallbladder disease
suicidal behavior/ ideation

33
Q

What is different between Saxenda and Semaglutide (WEGOVY) dosing?

A

SAXENDA: daily dosing
WEGOVY: weekly dosing

34
Q

How is WEGOVY dose increased?

A

over 16 weeks to minimize GI symptoms

35
Q

What are warnings with WEGOVY and ZEPBOUND?

A

Acute pancreatitis
Acute gallbladder disease

36
Q

What is the MOA of Tirzepatide (ZEPBOUND)?

A

GIP (glucose-dependent insulinotropic polypeptide) receptor agonist AND GLP-1 receptor agonist

37
Q

How is Tirzepatide dosed?

A

weekly

38
Q

What are BBWs with Tirzepatide?

A
  1. risk of thyroid C-cell tumors , including medullary thyroid carcinoma
  2. personal or family history of multiple endocrine neoplasia syndrome type 2

GI (23 decks)

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