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NAPLEX > Weight Loss > Flashcards

Weight Loss Flashcards

1
Q

BMI Parameters

A
  • Overweight = BMI: 25-29.9

- Obese = BMI >= 30

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2
Q

Drugs/Conditions for Weight Gain

A
  • Antipsychotics**
  • Diabetic drugs: insulin, meglitinides, sulfonylureas, TZD**
  • Divalproex/valproic acid**
  • Gabapentin/pregabalin**
  • Lithium
  • Mirtazapine**
  • Steroids**
  • TCAs
  • Conditions: Hypothyroidism
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3
Q

Drugs/Conditions for Weight Loss

A
  • ADHD drugs (amphetamines)
  • Bupropion
  • Diabetic Meds: GLP-1 agonists, Pramlintide, SGLT2i
  • Roflumilast
  • Topiramate
  • Conditions: Hyperthyroidism, celiac disease, IBD
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4
Q

OTC Supplements for Weight Loss

A
  • Bitter orange - OTC stimulant
  • Caffeine (AKA guarana and concentrated green tea powder) - OTC stimulant
  • Generally ineffective and not helpful, can harm those with CV disease
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5
Q

Rx Weight Loss Meds/Monitoring

A
  • Only indicated for obese patients or those with BMI >= 27 with a weight-related condition
  • Weight-related condition: diabetes, HTN, dyslipidemia
  • Should only be used as an addition to a dietary plan/increased physical activity
  • D/C meds if at least 5% weight loss hasn’t occurred in 12 weeks
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6
Q

Belviq/Belviq XR

A
  • Lorcaserin
  • 5HT2C agonist
  • Withdrawn from US market due to increased risk of cancer
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7
Q

Newer Stimulant Drug Options

A
  • Qsymia
  • Contrave
  • Saxenda
  • Orlistat formulations
  • *All can be used long-term for weight maintenance**
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8
Q

Preggos should avoid…

A

ALL weight loss drugs

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9
Q

HTN patients should avoid…

A
  • Contrave (CI with uncontrolled HTN due to bupropion component)
  • Caution with Qsymia (monitor HR due to phentermine)
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10
Q

Depression patients should avoid…

A
  • Caution in young adults and adolescents

- Contrave - suicide risk due to bupropion

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11
Q

Seizure patients should avoid…

A
  • Contrave (lowers seizure threshold)

- Qsymia (must be tapered slowly due to topiramate)

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12
Q

Opioids patients should avoid…

A

-Contrave (blocks opioid receptors)

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13
Q

Qsymia

A
  • Contains phentermine and topiramate ER
  • Phentermine - sympathomimetic (stimulant) that decreases appetite
  • Topiramate: increases satiety and decreases appetite
  • REMS drug due to teratogen risk
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14
Q

Qsymia Information

A
  • CI: pregnancy, glaucoma (MAOI use -HTN urgency, hyperthyroidism)
  • SE: tachycardia, insomnia, vision problems, cognitive impairment (“Stupamax”)
  • Taper off due to seizure risk
  • REMS drug due to teratogen risk
  • CIV
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15
Q

Contrave

A
  • Contains naltrexone and bupropion
  • Naltrexone decreases food cravings
  • Bupropion decreases appetite (increases NE/DA)
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16
Q

Contrave Information

A
  • CI: pregnancy, chronic opioid use, uncontrolled HTN, seizure disorder, use with other bupropion-products, MAOI use w/in 14 days
  • Warning: Caution with psychiatric disorders
  • Don’t take with high fat meals
  • Naltrexone blocks opioid and buprenorphine receptors
17
Q

Saxenda

A
  • Liraglutide (Victoza used for diabetes)
  • Injected SQ daily
  • Increases satiety, delays gastric emptying
18
Q

Saxenda Information

A
  • CI: pregnancy
  • Warning: pancreatitis and hypoglycemia
  • SE: nausea, GI effects, pancreatitis
  • REMS: medullary thyroid carcinoma and pancreatitis
19
Q

Xenical/Alli

A
  • Orlistat
  • Decreases absorption of dietary fats by ~30%
  • Must be used with a low-fat diet plan
20
Q

Orlistat Information

A
  • CI: Preggo
  • SE: GI (flatus w/ discharge, fatty stool, etc)
  • Take ADEK and beta-carotene supplement at bedtime or separated by drug by at least 2 hours
  • Max of 30% kcals from fat while on medication
  • Separate from cyclosporine and levothyroxine
21
Q

Adipex-P

A
  • Phentermine
  • Sympathomimetic that decreases appetite
  • CIV
22
Q

Bariatric Surgery

A
  • Recommended for adults with BMI >= 40 or when BMI >= 35 with a obesity-related condition
  • Restricts food intake leading to weight loss
  • Many nutrition and medication concerns
23
Q

Bariatric Surgery Nutrition Concerns

A
  • Calcium absorption may be bypassed: recommend calcium citrate (non-acid dependent)
  • Anemia from vitamin B-12 and iron deficiency can occur, supplement
  • Take iron and calcium supplements at least 2 hours before or 4 hours after antacids
  • Life-long ADEK supplementation may be required
24
Q

Bariatric Surgery Medication Concerns

A
  • Meds may need to be crushed and put into liquid or transdermal form for 2 months post-surgery
  • Pharmacists should assess which meds can safely undergo crushing and provide alternatives
  • Gallstones can occur with rapid weight loss, use Ursodiol to dissolve gallstones PRN
25
Q

Phentermine Information

A
  • CI: CVD (uncontrolled HTN), hyperthyroidism, MAOI use, glaucoma, preggo, and hx of drug abuse
  • SE: tachycardia, agitation, increased BP
  • Monitor: HR and BP
  • Use short-term, only up to 12 weeks, to “jump-start” diet
  • Stimulant so take in the morning! (insomnia)

NAPLEX (59 decks)

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