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Therapeutics 1 Kappa Epsilon Version > Overweight/Obesity Lecture > Flashcards

Overweight/Obesity Lecture Flashcards

1
Q

Common drug classes that cause obesity or overweight

A

Anticonvulsants; Antidepressants; Atypical antipsychotics; Conventional antipsychotics; Hormones

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2
Q

Examples of drugs that cause obesity - anticonvulsant drugs

A

carbamazepine; gabapentin; pregabalin; valproic acid;

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3
Q

Examples of drugs that cause obesity - antidepressants drugs

A

mirtazpine; tricyclic antidepressants

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4
Q

Examples of drugs that cause obesity - atypical antipsychotics drugs

A

clozapine; olanzapine; quetiapine; risperidone

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5
Q

Examples of drugs that cause obesity - conventional antipsychotics drugs

A

haloperidol

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6
Q

Examples of drugs that cause obesity - hormone drugs

A

corticosteroids; insulin; medroxyprogesterone

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7
Q

What criteria indicates a patient that would benefit from weight loss

A
  • BMI over 30

- BMI over 25 and 1 + risk factors

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8
Q

Non-Pharmacological Therapy - what 3 things to do lose weight

A

1 - reduced calorie intake
2 - increased physical activity
3 - behavioral strategies

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9
Q

Appropriate kcal/day levels for women for weight loss

A

1200 - 1500 kcal/day

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10
Q

Appropriate kcal/day levels for men for weight loss

A

1500 - 1800 kcal/day

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11
Q

Appropriate amount calories to cut per day to lose weight

A

500 - 750 kcal

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12
Q

Specific ways to increase adherence/interventions and counseling to use

A
  • onsite programs with trained professional

- encourage pts to BUILD UP exercise (up to 5 days a week of 30 minutes)

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13
Q

Criteria for bariatric surgery

A

BMI over 40 AND BMI over 35 + coexisting conditions AND motivated to lose weight AND has not responded to behavioral treatment (with or without pharmacotherapy)

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14
Q

Effects of bariatric surgery

A
  • reduce calorie intake

- ensure behavior modification through eating small amounts of food slowly and throughly chewing each mouthful

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15
Q

Average weight loss with bariatric surgery = ___ %

A

50% of body weight

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16
Q

5 classes of drugs for Prescription drug therapy options - LONG TERM

A
  • Lipase inhibitor
  • Serotonin 5-HTC2 receptor agonist
  • Symphathomimetic (CNS STIMULANT) and anticonvulsant
  • opioid antagonist/dopamine and norepinepherine reuptake inhibitor
  • GLP-1 agonist
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17
Q

Class of prescription drug that is for short term use for weight loss

A

CNS stimulants

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18
Q

Lipase inhibitor weight loss drug

A

Orlistat - Xenical or Alli

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19
Q

Orlistat is generic for ?

A

Xenical or Alli

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20
Q

Orlistat is apart of what kind of drug class

A

lipase inhibitor

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21
Q

Lorcaserin is generic for ?

A

Belviq

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22
Q

Belviq is apart of what kind of drug class

A

serotonin 5-HT2C Receptor agonist

23
Q

Qsymia is brand for what?

A

Phentermine and topiramate

24
Q

Qsymia is apart of what kind of drug class

A

sympathomimetic and anticonvulsant

25
Q

Contrave is brand for what?

A

Naltrexone and bupropion extended release

26
Q

Contrave is apart of what kind of drug class

A

opioid antagonist and dopamine/norepinephrine reuptake inhibitor

27
Q

Saxenda is brand for ?

A

liraglutide

28
Q

Saxenda is apart of what drug class

A

GLP-1 agonist

29
Q

BMI equation

A

Kg/ m^2 or lbs/in^2 x 703

30
Q

BMI ranges (for underweight, normal weight, overweight, obese)

A

under: < 18.5
normal: 18.5 - 24.5
over: 25 - 29.9
obese: over 30

31
Q

Waist circumfrences for females and males that indicate they are at a higher risk for issues

A

female if over 35 INCHES
male if over 40 INCHES
(dont forget to convert to cm if relevant)

32
Q

Potential complications from bariatric surgery

A

wound infections; GI leaks; DVT; depression; cholecystitis; fractures; vitamin deficiencies

33
Q

Mechanism or Orlistat

A

reversibly inhibits gastric and pancreatic enzymes - lipids (long chain TGs) not absorbed!

34
Q

Dosing of Xenical and Alli

A

Xenical - 120 mg TID
Alli - 60 mg TID

(Take within 1 hr of eating a fat-containg meal - dont take if you didnt eat)

35
Q

Contraindications (other than pregnancy): for Orlistat

A

cholestatis; chronic malabsorption syndrome

36
Q

Drug interactions with Orlistat

A

Levothyroxine; Warfarin (bc Vit.K); Cyclosporine; Multivitamins (bc fat soluble vitamins); Oral contraceptives (if lots of side effects of diarrhea)

37
Q

Common Side effects of Orlistat

A

Oily spotting, abdominal pain/discomfort, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, defecation increased

38
Q

Mechanism of action for Belviq (Lorcaserin)

A

will ACTIVATE serotonin-5HT2C in the hypothalamus to result in satiety/decreased food intake

39
Q

Dosing of Belviq (Lorcaserin)

A

10 mg BID
OR
20 mg QD (if Belviq XR)

40
Q

Which drug is allowed by FDA for kids over 12 years old

A

Xenical - Rx only

41
Q

Which drug is contraindicated with patients that have glaucoma

A

Qsymia - phentermine/topiramate
and
(Contrave - may cause narrow angle glaucoma - do not use either!!!)

42
Q

Which weight loss drugs should not be used in patients with alcoholism or addictoin

A

Contrave - the bupropion part will lower seizure threshold

43
Q

Which weight loss drugs can breastfeeding mothers use?

A

NONE - none recommended at all

44
Q

Which weight loss drug should not be used by opioid users

A

Contrave - bc naltrexone component

45
Q

Which drug should not be used by patients with a history of pancreatitis

A

Saxenda/ liraglutide

46
Q

Which weight loss drug should patients with hypertension avoid

A

Contrave - (because of uncontrolled hypertension)

47
Q

Which weight loss drugs can type 2 diabetics use?

A

All of them are ok!

48
Q

Which weight loss drugs can SEVERE hepatic impairment patients use?

A

NONE - all bad for them

if just mild - to moderate impairment - use all with caution

49
Q

Which weight loss drug should patients with seizure disorders avoid?

A

Contrave - because of bupropion portion

50
Q

Which weight loss drug should not be used in patients with a history of thyroid cancer

A

Saxenda

51
Q

Common adverse reactions with Saxenda

A

irritation at injection site and HYPOGLYCEMIA and GI effects

52
Q

Mechanism of Saxenda

A

it is GLP-1 agonist - reduction of food intake/SLOWS gastric emptying

53
Q

Main contraindications with Contrave

A
  • opioid use or other bupropion use
  • uncontroleld HTN
  • seizure disorder
54
Q

Dosing of Contrave and “how” to take it

A
  • titrate up to 2 AM and 2 PM

- do NOT with a high fat meal

Therapeutics 1 Kappa Epsilon Version (17 decks)

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