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NAPLEX 2021 > Weight Loss > Flashcards

Weight Loss Flashcards

1
Q

Overweight BMI

A

25-29.9 kg/m^3

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2
Q

Drugs that can cause weight gain

A 
antipsychotics 
insulin
sulfonylureas 
divalproex/valproic acid 
gabapentin 
lithium
mirtazapine 
steroids 
TCS (amitriptyline, nortiptyline)
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3
Q

antipyschotics that cause major weight gain

A

clozapine
olanzapine
risperidone
quetiapine

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4
Q

What thyroid disorder can cause weightgain?

A

hypothyroidism

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5
Q

OTC weight loss supplements

A 
bitter orange 
caffeine
guarana
green tea powder
*ineffective, harmful in CVD patients
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6
Q

Indication for rx weight loss drugs

A

BMI >30
or
BMI>27 with at least 1 weight related condition (HTN, dyslipidemia, diabetes)

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7
Q

Long-term stimulant options

A

Qsymia
Contrave
Saxenda
Orlistat

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8
Q

When to dc weight loss drugs

A

If 5% of weight loss hasn’t been achieved at 12 weeks of use

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9
Q

Lorcaserin (Belviq)

A

withdrawn from US due to risk of cancer

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10
Q

What weight loss drugs are safe in pregnancy

A

NONE!

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11
Q

When should Contrave be avoided?

A

HTN, caution in YA (suicide risk), Seziures, pts taking opioids
*remember, contains buproprion (lowers seziure threshold) and naltrexone

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12
Q

When to use caution with Qsymia

A

HTN and seizures (taper off)

phentermine and topiramate

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13
Q

Which weight loss drug has a REMS program due to teratogenic risk

A

Qsymia

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14
Q

Qsymia MOA

A

phentermine: sympathomimetic (stimulant), releases norepi to stimulate satiety center and decrease appetite
topiramate: increases satiety and decreases appetite by increases GABA, blocks glutamate receptors and inhibits carbonic anhydrase

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15
Q

Contrave MOA

A

naltrexone: decreases cravings
buproprion: decreases appetite

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16
Q

Saxenda MOA

A

liraglutide (GLP-1 agonist) increases satiety
risk of thyroid carcinoma
warning for pancreatitis
GI side effects

17
Q

What other drug is Saxenda like

A

Victoza (both are liraglutide)

18
Q

Orlistat

A

OTC: Alli Rx: Xenical
must be used with a low fat diet plan (max 30% daily kcal)
GI effects including oily stool
Separate from multivitamins

19
Q

List of stimulants

A

phentermine (adipex)
diethylpropion
phendimetrazine
benzphetamine

20
Q

Longest time frame to use stimulants

A

12 weeks

21
Q

CI for stimulants

A 
CVD
HTN
Drug abuse hx
hyperthyroidism 
glaucoma 
HF
Arrthymias
22
Q

Guidelines for bariatric surgery

A

BMI >40 or >35 with obesity related condition

23
Q

What drug may be needed post-bariatric surgery unless gallbladder is removed

A

Ursodiol (actigall): dissolves gallstones which are a high risk after rapid weight loss

NAPLEX 2021 (28 decks)

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