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Naplex > 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

Under weight BMI

A

<18.5 kg/m2

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4
Q

Normal weight BMI

A

18.5 - 24.9 kg/m2

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5
Q

Select drugs/conditions that can cause weight gain

A

Drugs:

  • Antipsychotics (e.g., clozapine, risperidone, quetiapine)
  • Diabetes drugs (insulin, SUs, meglitinides,
    TZDs)
  • Divalproex/valproic acid
  • Gabapentin, pregabalin
  • Lithium
  • Mirtazapine
  • Steroids
  • TCAs (amitriptyline, nortriptyline)

Conditions: Hypothyroidism

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6
Q

OTC drugs for weight loss

A
  • Bitter orange
  • Caffeine
  • Guarana
  • Green tea powder
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7
Q

Which medication was withdrawn from the market due to risk of cancer?

A

Lorcaserin (Belviq, Belviq XR)

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8
Q

Weight loss medications should be __ if they do not produce at least __ weight loss at __weeks

Fill in the blank

A
  • Discontinued, 5%, 12
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9
Q

Select drugs/conditions that can cause weight loss

A

Drugs:
* ADHD drugs

  • Bupropion
  • GLP-1 agonists
  • Pramlintide
  • SGLT2 inhibitors
  • Topiramate

Conditions: Hyperthyroidism, Celiac disease, IBD

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10
Q

Weight Loss drugs: Hypertension

Which medications to avoid/use caution if having HTN? Why?

A

Avoid: Contrave
* Contraindicated with uncontrolled BP, contains bupropion

Caution: Qsymia
* Monitor HR, contains phentermine

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11
Q

Weight loss drugs: Depression

Which medication to avoid/use caution if having depression? Why?

A

Caution: Contrave
* In young adults and adolescents; suicide risk, contains bupropion

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12
Q

Weight loss drugs: Seizures

Which medication to avoid/use caution if having seizures? Why?

A

Avoid: Contrave
* Lowers seizure threshold, contains bupropion

Caution: Qsymia
* Must taper off slowly if used, contains topiramate

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13
Q

Weight loss drugs: Taking opioids

Which medication to avoid/use caution when taking opioids? Why?

A

Avoid: Contrave
* Blocks opioid receptors, contains naltrexone

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14
Q

Qsymia: generic, indications safety/SEs/monitoring

A
  • Phentermine/topiramate (C-IV)
  • REMS initiated due to teratogenic risk
  • CIs: pregnancy, glaucoma
  • SEs: tachycardia, insomnia, vision problems

MOA:
* Phentermine: sympathomimetic (stimulant); release of NE stimulates the satiety which decreases appetite

  • Topiramate: increase satiety and decrease appetite, possibly by increasing GABA
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15
Q

Contrave: generic, indications safety/SEs/monitoring

A
  • Naltrexone/bupropion
  • CIs: pregnancy, chronic opioid use, uncontrolled HTN, seizure disorder, use of of other bupropion containing products and MAO inhibitors
  • Warnings: caution with psychiatric disorders

MOA:
* Naltrexone: decreases food cravings, blocks opioids
* Bupropion: decreases appetite

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16
Q

Which GLP-1 agonist can be used for weight loss? Provide safety/SEs/monitoring parameters

A
  • Liraglutide (Saxenda); SC daily
  • CIs: pregnancy
  • Warnings: pancreatitis, hypoglycemia
  • SEs: nausea

MOA: Increases satiety

17
Q

Lipase Inhibitor: generic, indications safety/SEs/monitoring

A

MOA: Decreases absorption of dietary fats by ~30%

Orlistat
* Rx: Xenical, OTC: Alli

  • Must be used with a low-fat diet plan
  • CIs: pregnancy
  • SEs: GI (flatus with discharge, fatty stool)
  • Take multivitamin ADEK and beta carotene at bedtime or separated by more than or equal to 2 hrs
18
Q

What is Phentermine used for?

Safety/SEs/Monitoring

A

Appetite supressant; sympathomimetic (stimulant)
Phentermine (Adipex-P): C-IV
* CIs: cardiovascular disease, hyperthyroidism, glaucoma, pregnancy, hx of drug abuse

  • SEs: tachycardia, agitation, increased BP
  • Used short-term, up to 12 weeks
19
Q

When is bariatric surgery necessary?

A

When:
* BMI is >= 40 kg/m2

  • BMI >= 35 kg/m2 with an obesity-related condition
20
Q

Common nutrient deficiencies

A
  • Calcium citrate is preferred as it has non-acid dependent absorption
  • Anemia can result from vitamin B12 and iron deficiency
  • Iron and calcium supplements should be taken 2 hrs prior or 4 hrs after antacids
  • Patient may require life long ADEK vitamins
  • Medications may be crushed and put in liquid or used in transdermal form up to two months post-surgery
  • Ursodiol can be used in case of a gallstone

Naplex (20 decks)

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