Weight Loss

Question 1

what drugs/conditions cause weight gain

Answer 1

steroids
BBs
insulin, SUs, meglitinides, TZDs
APs (clozapine, olanzapine, risp, quet)
gabapentin, pregabalin
TCAs
VPA
MAO-i
hormones
SSRIs
__________________

hypothyroidism

Question 2

what drugs/conditions cause weight loss

Answer 2

topiramate
GLP-1s
SGLT2-i
bupropion
amphetamines
__________________

lupus
CF
celiacs
GERD
PUD
hyperthyroidism
TB

Question 3

what OTC supplements are there for weight loss? are these recommended

Answer 3

bitter orange
caffeine
Alli (orlistat)

Question 4

what qualifies a patient to receive a weight loss medication

Answer 4

BMI 30+ or
BMI 27+ with a weight-related condition (HLD, HTN, DM)

Question 5

meds are always in addition to _________

Answer 5

lifestyle

Question 6

what is the role of oral meds for weight loss

Answer 6

kick start
usually not for extended periods of time

Question 7

what is the target weight loss for a patient on a weight loss med

Answer 7

5+% weight loss in 12 weeks

Question 8

what is in Qsymia

Answer 8

phentermine/topiramate ER

Question 9

Qsymia (phentermine/topiramate ER) is CI in

Answer 9

pregnancy, glaucoma, hyperthyroid, MAO-i

Question 10

what are possible SE of Qsymia?
SATA

A. tachycardia
B. hypotension
C. depression
D. anxiety
E. psych disturbances
F. HA
G. vision changes

Answer 10

A. tachycardia

C. depression
D. anxiety

F. HA
G. vision changes

causes hypERtension

Question 11

how should Qsymia be discontinued

Answer 11

with a taper
contains topamax and can increase seizure risk with abrupt d/c

Question 12

which weight loss treatment has a REMS program

Answer 12

Qsymia (phentermine/topiramate ER)

Question 13

Contrave containe

Answer 13

naltrexone/bupropion

Question 14

Contrave is not approved for

Answer 14

MDD or psych dx

Question 15

Contrave is CI in

Answer 15

kids, seizure disorder, opioid use, bulimia/anorexia, MAO-i, uncontrolled HTN

Question 16

what are the GLP-1s approved for weight loss (brand and generic)?

Answer 16

saxenda (liraglutide)
Wegovy (semaglutide)

Question 17

saxenda dosing

Answer 17

0.6mg SQ once daily
increase daily dose by 0.6mg once weekly to a target dose of

3mg SQ daily

Question 18

wegovy dosing

Answer 18

0.25mg SQ weekly x4 weeks
titrate q4weeks to a target dose of 2.4mg SQ weekly

Question 19

what are concerns with GLP-1 RAs

Answer 19

CI PMH or FH of medullary thyroid carcinoma or MEN2 syndrome

can cause pancreatitis, gastroparesis, hypoglycemia, nausea

may need to lower dose of insulins, SUs, meglitnides!

Question 20

what are the brand names for orlistat

Answer 20

Alli = OTC
Xenical = Rx

Question 21

orlistat MOA

Answer 21

decreases dietary fat absorption by ~30%

Question 22

warnings for orlistat

Answer 22

liver damage
cholelithiasis
separate ADEK by 2+ hrs
max of 30% of kcals can be from fats

Question 23

phentermine brand name

Answer 23

Adipex-P

Question 24

phentermine dosing and duration

Answer 24

7.5-37.5mg PO QD x</= 12 weeks

Question 25

what conditions are CI for phentermine

Answer 25

CVD, pregnancy, glaucoma, hx drug abuse, MAO-i, hyperthyroidism

Question 26

who qualifies for bariatric surgery

Answer 26

BMI 40+
BMI 35+ + 1 obesity related condition

Question 27

bariatric surgery can cause deficiencies in

Answer 27

ADEK
Ca
B12
iron