Obesity Flashcards Preview

662 > Obesity > Flashcards

Flashcards in Obesity Deck (22):
1

What are the causes of obesity?

The fat computer programmer sit in his cubical all day chugging coconut milk. His boss is always yelling about deadlines. And sometimes his imaginary friend Pedro comes to visit showing him how to inject steroids with insulin needles. Genetically he is a preditor and shouts "Fuck The Oakleys". To top it all of his gf isnt on contraceptives. 

  • High calorie diet
  • No activity
  • Stress
  • Medications
    • Antipsychotics, Contraceptive, steroids, insulin, sulfonylureaus 
  • Gentics
    • Prader-Willi, FTO gene

2

Obese class 1,2,3 BMI

 

30-34.9

35-39.9 

> = 40 

3

Management of obesity 1 

A image thumb
4

Management of obesity 2

A image thumb
5

Diet to lose fat

Reduce calorie intake 

500-100 kcal/day 

goal 800-1200

6

Exercise

150 minutes

7

Behavior stuff?

  • Support group
  • Realistic goals
    • SMART/FITT
    • Shitty goal- I want to lose weight
    • SMART goal- eat 1500 calories per wk day and excercise for 30 minutes everyday loss 10 lbs
  • Self monitoring

8

Antiobesity Agents

Orlistat

DIs?

Vit K?

Take MVi 2 hours before or after

120 mg tid rx 

>= 12 

60 mg TID OTC

Seperate from levothyroxine by 1 hour

Monitor INR with vit K antagonist

reduces amiodarone efficacy 

9

Lorcaserin 

Dose

DI

AE

10 mg BID BMI > 30 BMI 27 with other comorbidities

Nausea headache, fatigue dizzy

Not to be used if pregnant, Valv HD, ESRD, caution in CHF, HTN, hyperprolactinemia

10

Phentermine/topiramate ER

Initial dose 3.75/23 mg for 14 days then 7.5/46 daily 

may increase to 11.25/69 mg daily for 14 days 

15/92 daily 

Not to be used if pregnant, glaucoma, hyperthyroidism, MAOIs, suicide, moderate high CVD

Caution with renal or haptic impairment 

11

Bupropion/naltrexone dosing

 

Wk1 - 1 tab am

2 1 tab bid

3 2 am 1 pm

4 2 tabs BID

Dont use in uncontrolled HTN, Seizure, bulimia, anorexia, prgnant

Caution in renal hepatic impairment

 

12

Liraglutide

Start with 0.6 mg SQ daily and increase by 0.6 weekly to dose of 3 mg 

Lots of nausea, 

No in thyroid cancer, pregnant, pancreatitis, 

Renal 

13

Dosing summary

A image thumb
14

When do you refer for bariatric surgery?

BMI >= 40 or 35 with additional comorbidiies 

Very successful 

15

Many types of bariatric surgery

Bands, Sleeve, bypass, 

All reduce stomach volume

16

Patients that have gotten surgery should avoid?

ER drugs

need compounds or liquids 

No NSAIDs

17

____ Most common procedure?

RNYGB

need vitamins

18

Exam questions 

A image thumb
19

Medication follow-up

A image thumb
20

Medication discontinuation

A image thumb
21

Surgery follow up 

A image thumb
22

When should Lorcaserin be used?

Patients with a BMI of > = 30 or BMI >= 27 with additional comorbidities