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Naplex 2023 > Weight Loss > Flashcards

Weight Loss Flashcards

1
Q

overweight BMI

A

25-29.9 kg/m2

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2
Q

obese BMI

A

> =30 kg/m2

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3
Q

risks of being overweight

A

coronary heart disease
hypertension
stroke
T2DM

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4
Q

2 things that make body use fat as resource

A

decreasing calories
increasing energy. expenditure

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5
Q

drugs/conditions that cause weight gain

A

antipsychotics: clozapine, olanzapine, risperidone, quetiapine

diabetes: insulin, meglitinides, sulfonylureas, TZDs

divalproex/valproic acid

Gabapentin/pregabalin

lithium

mirtazapine

steroids

TCAs (amitriptyline, nortripttyline, etc.)

beta-blockers

dronabinol

hormones (estrogen, megestrol, etc)

MAOIs

SSRIs (paroxetine, others could be weight neutral)

vasodilators (minoxidil, etc)

condition: hypothyroidism

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6
Q

Drugs/conditions that cause weight loss

A

ADHD drugs (amphetamine, methylphenidate, etc.)

Gupropion

GLP-1 (exenatide, liraglutide, etc.)

Pramlintide

Roflumilast

SGLT2i (canagliflozin, empagliflozin, etc.)

Topiramate

Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine)

antiepileptic drugs: zonisamide, ethosuxamide

Interferons

Thyroid drugs (levothyroxine, etc.)

conditions: hyperthyroidism, celiac, IBS, cystic fibrosis, GERD/peptic ulcer, lupus, TB (active)

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7
Q

physical activity for weight loss

A

> =150 minutes/week over 3-5 separate days

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8
Q

OTC supplements for weight loss

A

bitter orange - stimulant

caffeine (in things like guarana, green tea powder too)

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9
Q

when are prescription drugs for weight loss appropriate

A

BMI >=30 or >=27 with 1+weight-related condition (dyslipidemia, HTN, DM)

in addition to diet and inc physical activity

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10
Q

what to avoid/use with caution prescription weight loss drugs in pregnancy

A

avoid all

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11
Q

what to avoid/use with caution prescription weight loss drugs in hypertension

A

Contrave CI with untrolled BP (has bupropion)

Qsymia: caution; monitor hR (has phentermine)

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12
Q

what to avoid/use with caution prescription weight loss drugs in depression

A

Contrave - caution in young adults/adolescents (suicide risk; contains bupropion)

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13
Q

what to avoid/use with caution prescription weight loss drugs in seizures

A

avoid: Contrave; lowers seizures threshold (Bupropion included)

caution: Qsymia, taper off slowly if used (has topiramate)

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14
Q

what to avoid/use with caution prescription weight loss drugs when taking opioids

A

avoid: Contrave - blocks opioid receptions (has naltrexone)

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15
Q

newer drugs that can be continue long-term

A

Qsymia,Contrave, Saxenda, Wegovy

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16
Q

when should weight loss drugs be stopped

A

<5% weight loss at 12 weeks

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17
Q

phentermine MOA

A

sympathomimetic/stimulant

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18
Q

phentermine CI

A

pregnancy - REMS drug bc teratogenic risk

glaucoma

19
Q

phentermine side effects

A

tachycardia

CNS effects (insomnia)

vision problems

20
Q

phentermine notes

A

taper off bc seizure risk

21
Q

Contrave MOA

A

naltrexone - dec food cravings
Bupropion - dec appetite

22
Q

Contrave CI

A

pregnancy

chronic opioid use

uncontrolled HTN

seizure disorder

use of other bupropion-containing products

use of MAOIs within 14 days

23
Q

Contrave warnings

A

caution with psychiatric disorders

24
Q

Contrave notes

A

Naltrexone block opiois

25
Q

GLP-1 MOA

A

Saxenda, Wegovy: inc satiety

Vicoza, Ozempic: for DM only

26
Q

liraglutide/Saxenda dosing

A

SC daily injection

27
Q

semaglutide/Wegovy disong

A

SC weekly injection

28
Q

GLP-1 CIs

A

Saxenda: pregnancy

29
Q

GLP-1 warnings

A

pancreatitis

hypoglycemia

30
Q

GLP-1 side effects

A

nausea

31
Q

lipase inhibitors MOA

A

Orlistat, Xenical (Rx), Alli (OTC)

dec abs of dietary fat by 30%

32
Q

lipase inhibitor CI

A

pregnancy

33
Q

lipase inhibitor side effects

A

GI (flatus with discharge, fatty stool

34
Q

lipase inhibitor notes

A

take multivitamin with A, D, C, K, E and beta carotene at bedtime or separated by >=2 hrs from lipase inhibitors

35
Q

sympathomimets/stimulants MOA

A

Phentermine/Adipex-P

sympathomimetics/stimulants

stick to diet according to iron tribe, max 30% of calories done in her practice

36
Q

phentermine MOA

A

sympathomimetic/stimulant

37
Q

phentermine CI

A

CV disease (uncontrolled HTN)

hyperthyroidism

glaucoma

pregnancy

drug abuse history

38
Q

phentermine side effects

A

tachycardia

agitation

inc BP

39
Q

phentermine monitoring

A

HR, BP

40
Q

when to usephentermine

A

short-term, up to 12 seeks, “jump start”

41
Q

when to use bariatric surgery

A

BMI >=40 kg/m2

BMI >=35 kg/m2 with obesity-related condition

42
Q

bariatric surgery common nutrient deficiencies

A

calcium citrate (preferred calcium; non-acid dependent absorption)

vit b12

iron deficiency

iron and calcium - take 2 hrs before or 4 hrs after antacids

may need life-long of DEAK

43
Q

bariatric surgery medication concerns

A

may need to crush or put in liquid or use transdermal for up to 2 months post-surgery

rapid weight loss: might need meds that get ride of gallstones; Ursodiol (Urso 250, UrsActigall, Urso Forte)

Naplex 2023 (21 decks)

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