Eating Disorders Flashcards
(31 cards)
With eating disorders… when in doubt, do what?
REFER TO A SPECIALIST
What is SCOFF?
do you make yourself SICK
have you lost CONTROL
have you lost more the ONE stone… 14lbs
do you believe to be FAT
does FOOD dominate your life?
2+ = positive screen
What is the most serious eating disorder and what are the three main signs of this disorder?
Anorexia Nervosa
Low body weight
Restricting Calories
Intense fear of gaining wt
Mackenzie loves ortho…. what ortho concern do you need to have with patients who appear to have an eating disorder
> 90% of A.N patients have osteoporosis… it is a massive issue so SCREEN FOR STRESS FRACTURES
What is the first line treatment for eating disorders…. think carefully FIRST LINE BEST TREATMENT?
Psychotherapy
What is the first line medication for A.N.?
Fluoxetine- Prozac
When would you give adjunctive therapy to A.N. patients?
if they suffer from depression, anxiety or bipolar disorder.
Can treat what is around the E.D.
SSRI’s can help what two qualities in A.N patients?
depressive symptoms and ritualistic behaviors
Low dose atypical antipsychotics can be used for what kind of characteristics in A.N. patients?
severely obsessional or severely agitated patients
What drug should you avoid giving to patients with an eating disorder due to the increased risk of addiction?
benzodiazepines
What SSRI has the longest half life and the least amount of withdrawal symptoms?
Fluoxetine | Prozac
What SSRI has the shortest half life and many withdrawn side effects?
Peroxytine | Paxil
What drug can cause jitteriness, sleep disturbances, and with breast feeding the infants appetite may be supressed
Prozac
What SSRI should you use for a pregnant woman?
Zoloft
What SSRI should be avoided in anorexic patients due to the potential that they might already have QTC prolongation?
Citalapram- Celexa
Escitalapram- Lexapro
What SSRI should not be used in pregnant women and also contributes to dry mouth, constipation, and sexual dysfunction
Peroxytine - Paxil
How many episodes and over how many months do bulimia nervosa patients have to have bulimia nervosa acts to be considered to have the disorder?
at least once a week for 3 month
Is suicide risk higher in patients with anorexia or bulimia?
bulimia
what are some signs on physical exam that a patient may have B.N.?
chronic vomiting causes:
- Perimyololysis - dental erosions
- parotid glad enlargement
- oral/pharyngeal damage
- gastric tears
- electolyte embalance K+
- laxative abuse
- dehydration
- alternating constipation and diarrhea
What is the first line medication for bulimia nervosa?
Fluoxetine
What is second and third line treatments for B.N and the problems with the 3rd line txs.?
Second: any SSRI
Third: (3 T’s)
- TCA - easy to OD
- TOPAMAX - wt. loss
- TRAZADONE-sedating
What specific drug is contraindicated in all eating disorders due to eating disorder patients already having a decreased sz threshold?
Buproprion/Wellbutrin
Does binge eating have fasting and purging episodes?
No!
anorexia and bulimia always trump the diagnosis of binge eating.
Binge eating is eating excessive amounts of food esp. to the point of shame and being uncomfortable
What comorbidities are likely to develop with binge eating disorder?
Chronic Pain Diabetes Hypertension Obesity OTHER MENTAL ILLNESS
