Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 852 Public Health > Obesity/Weight Loss Pharmacotherapy Colemen > Flashcards

Obesity/Weight Loss Pharmacotherapy Colemen Flashcards

1
Q

who are candidates for pharmacotherapy?

A

BMI > or = to 30 OR BMI > or = to 27 with other risk factors (HTN, diabetes, dyslipidemia, etc) AND did not lose weight OR maintain weight with comprehensive lifestyle intervention (< 5% loss in 3-6 months of actively trying)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

initial goal for reduction of body weight: ___ to ___ % of initial weight over ___ months

A

5 to 10%; 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

after initiating pharmacotherapy, when should we follow up?

A

-every month for the first 3 months of therapy
-after first 3 months, follow up every 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what class of drugs are short-term pharmacotherapy options?

a. lipase inhibitors
b. GLP-1 agonists
c. CNS stimulants
d. melanocortin receptor agonist

A

c. CNS stimulants

(ex. phentermine, phendimetrazine, benzphetamine, diethylpropion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MOA of CNS stimulants: inc conc of __________ to stimulate receptors in hypothalamus, resulting in appetite suppression

A

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Orlistat (Xenical or Alli) is in what drug class?

a. lipase inhibitors
b. sympathomimetic/anticonvulsant
c. GLP-1 agonists
d. melanocortin receptor agonist

A

a. lipase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

is Xenical (Orlistat) Rx or OTC?

A

Rx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

is Alli (Orlistat) Rx or OTC?

A

OTC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MOA of Orlistat (3 things)

A

-reversibly inhibits gastric and pancreatic lipases
-dec absorption of dietary fats by ~30%
-minimally absorbed and does not work systemically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when should Xenical or Alli (Orlistat) be taken?

A

within 1 hour of eating a fat-containing meal

(omit dose if meal is missed or does not contain fat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Xenical is approved for what age?

A

12 and up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Alli is approved for what age?

A

18 and up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Orlistat is suggested for pts with what disease?

A

CV disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

common adverse effects of Orlistat (2)

A

-GI
-dec absorption of fat sol. vitamins from diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CIs of Orlistat (3 of them)

A

-pregnancy
-chronic malabsorption syndrome
-cholestasis (slow/blocked bile flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Qsymia is a combo of what 2 drugs?

A

phentermine and topiramate ER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what class is Qsymia in?

a. lipase inhibitors
b. sympathomimetic and anticonvulsant
c. opiod antag and dopamine/norepi reuptake inhibitor
d. melanocortin receptor agonist

A

b. sympathomimetic and anticonvulsant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what drug class is Contrave in?

a. lipase inhibitors
b. sympathomimetic and anticonvulsant
c. opiod antag and dopamine/norepi reuptake inhibitor
d. melanocortin receptor agonist

A

c. opiod antag and dopamine/norepi reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what two drugs make up Contrave?

A

naltrexone and bupropion XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MOA of phentermine (sympathomimetic amine)

A

-stimulates hypothalamus to release norepi, which stimulates the satiety center, decreasing appetite

20
Q

Qsymia increases what 3 neurotransmitters to dec appetite and cravings?

A

-norepinephrine
-dopamine
-serotonin

21
Q

what schedule controlled substance is Qsymia?

A

C-IV

22
Q

if you are on max dose of Qsymia (15/92 mg) and 5% of baseline weight has not been lost after 12 weeks, what should you do?

A

gradually discontinue

23
Q

do not exceed phentermine/topiramate ER 7.5/46 gm once daily with CrCl < ___ mL/min

A

30

24
Q

for moderate hepatic impairment, do not exceed what dose of Qsymia once daily?

A

7.5/46 mg

25
Q

true or false: Qsymia is not recommended in dialysis or severe hepatic impairment patients

A

true

26
Q

what time of day should Qsymia be taken?

A

morning to prevent insomnia

27
Q

how should Qsymia be gradually decreased?

A

take every other day for at least one week prior to discontinuing

28
Q

true or false: Qsymia is allowed for pregnant patients

A

false (need to do REMS program due to teratogenicity)

29
Q

dosing schedule for naltrexone/bupropion ER (Contrave)

A

-supplied as naltrexone 8 mg/bupropion 90 mg ER tablets
-week 1 -> 1 tablet once daily in morning
-week 2 -> 1 tablet BID
-week 3 -> 2 tablets in morning and 1 in evening
-week 4 -> 2 tablets BID

30
Q

max daily dose of Contrave

A

4 tablets (naltrexone 32 mg/bupropion 360 mg)

31
Q

Contrave can cause an inc in _____ _____

A

blood pressure (so wouldn’t be appropriate for pt with HTN)

32
Q

true or false: Contrave should be taken with a high fat meal

A

false

33
Q

boxed warning for Contrave

A

suicidality

34
Q

true or false: Contrave is CI in pregnancy

A

true

35
Q

MOA of liraglutide (Saxenda) and semaglutide (Wegovy)

A

GLP-1 receptor agonist

36
Q

boxed warning of Saxenda and Wegovy

A

thyroid C-cell tumors

37
Q

liraglutide (Saxenda) dosing

A

-start at 0.6 mg daily x 1 week, inc by 0.6 mg/day every week
-target dose: 3 mg/day

38
Q

when to discontinue Saxenda

A

if 5% weight loss not achieved after 16 weeks of therapy

39
Q

Wegovy dosing (probably don’t need to know this)

A

-start at 0.25 mg once weekly for 1 month
-month 2: 0.5 mg each week
-month 3: 1 mg each week
-month 4: 1.7 mg each week
-month 5 and onward: 2.4 mg each week

(target dose is 2.4 mg once weekly)

40
Q

which drug is a melanocortin receptor antagonist?

A

setmelanotide (Imcivree)

41
Q

setmelanotide (Imcivree) MOA

A

-melanocortin-4 (MC4) receptor agonist (these receptors in brain are involved in regulation of hunger, satiety, and energy expenditure)

42
Q

which drug is used for pts with a genetic disorder in POMC, PCSK1, and LEPR genes?

a. Wegovy
b. Contrave
c. Qsymia
d. Imcivree

A

d. Imcivree (setmelanotide)

(deficiency in these genes impair MC4 pathway)

43
Q

setmelanotide (Imcivree) dosing for ages 12 and up

A

start at 2 mg once daily for 2 weeks, target dose is 3 mg once daily

44
Q

monitoring parameters for alternative therapies

A

-recommended closely monitoring during initial 6 months of treatment
-follow up every 4 weeks

45
Q

what drug is approved for patients > 6 years of age with Bardet-Biedl syndrome (BBS), or POMC, PCSK1, or LEPR deficiency?

A

Imcivree (setmelanotide)

46
Q

which drug should not be used in pts with hypertension?

a. stimulants
b. Orlistat
c. Saxenda
d. Contrave

A

d. Contrave

47
Q

what are the 4 CNS stimulants? (slide 8)

A

-phentermine (Adipex-P or Lomaira)
-phendimetrazine
-benzphetamine (Regimax)
-diethylpropion

PHRM 852 Public Health (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions