Hematology and Nutrition Flashcards
(21 cards)
What is the first line treatment for weight loss?
Always non-pharmacological approaches 1st :)
When can surgery be considered for weight loss?
If BMI 40 or more, there’s treatment failure or the presence of other risk factors
What medications have potential to contribute to weight gain?
Antidepressants, antipsychotics, antihyperglycemics, anticonvulsants, corticosteroids, CHC, cetirizine
When should pharmacological agents for weight loss be considered?
BMI 30 or more OR 27 or higher + comorbidities (T2DM, sleep apnea, dyslipidemia, HTN, metabolic-dysfunction steatotic liver disease)
What are some medications that are useful for weight loss in individuals with relevant comorbidities (no official weight loss indication)?
Metformin, bupropion (antidepressant, smoking cessation), fluoxetine (antidepressant), topiramate (anticonvulsant)
What are some contraindications for GLP-1’s?
Hx or fam hx of medullary thyroid cancer, pregnancy/breastfeeding, hepatic impairment
How often is the dose of semaglutide titrated up?
Every 4 weeks or as tolerated, target dose of 2.4 mg weekly
How often is the dose of liraglutide titrated up?
Weekly or as tolerated until at targeted dose of 3 mg daily
What is another medication used for weight loss?
Orlistat (GI lipase inhibitor)
What education needs to be provided when a patient is started on Orlistat?
Medication must be taken with fatty meal, if meal is missed or has no fat should omit dose
What are some adverse effects of Orlistat?
Loose stools, oil spotting, fecal urgency, mild decrease in BP, pedal edema
What are some pharmacological tx options for bulimia nervosa?
SSRIs (fluoxetine 20-60 mg daily), serotonin modulator (trazadone 100-500 mg daily), SNRIs (venlafaxine 75-150 mg daily)
What are the goals of therapy for anemia?
Alleviate symptoms, restore adequate/normal Hb levels, improve QOL and functional status, prolong survival
What is the preferred pharmacological approach for iron-deficient anemia?
Ferrous salts
When is parenteral iron therapy indicated?
When malabsorption, intolerance to oral medication, or need for rapid replenishment
Which iron supplement has the most amount of elemental iron?
Polysaccharide-iron complex (FeraMAX, etc.)= 150 mg elemental iron
What are some adverse effects of iron supplements?
GI upset, constipation and/or diarrhea
What can effect iron supplement absorption?
Food and certain drugs (antacids, calcium carbonate, cholestyramine, levodopa, methyldopa, quinolones, sodium bicarb, tetracyclines)- should separate administration by approx. 2 hours
What is megaloblastic anemia?
Caused by deficiency in Vit B12 or folate
What is the therapy for pernicious anemia?
Usually IM/SC or high dose oral B12(500-2000 mcg daily PO)
