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Therapeutics I - Spring 2017 > Overweight/Obesity Lecture > Flashcards

Overweight/Obesity Lecture Flashcards

1
Q

Common drug classes that cause obesity or overweight

A

Anticonvulsants; Antidepressants; Atypical antipsychotics; Conventional antipsychotics; Hormones

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2
Q

Examples of drugs that cause obesity - anticonvulsant drugs

A

carbamazepine; gabapentin; pregabalin; valproic acid;

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3
Q

Examples of drugs that cause obesity - antidepressants drugs

A

mirtazpine; tricyclic antidepressants

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4
Q

Examples of drugs that cause obesity - atypical antipsychotics drugs

A

clozapine; olanzapine; quetiapine; risperidone

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5
Q

Examples of drugs that cause obesity - conventional antipsychotics drugs

A

haloperidol

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6
Q

Examples of drugs that cause obesity - hormone drugs

A

corticosteroids; insulin; medroxyprogesterone

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7
Q

What criteria indicates a patient that would benefit from weight loss

A
  • BMI over 30

- BMI over 25 and 1 + risk factors

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8
Q

Non-Pharmacological Therapy - what 3 things to do lose weight

A

1 - reduced calorie intake
2 - increased physical activity
3 - behavioral strategies

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9
Q

Appropriate kcal/day levels for women for weight loss

A

1200 - 1500 kcal/day

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10
Q

Appropriate kcal/day levels for men for weight loss

A

1500 - 1800 kcal/day

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11
Q

Appropriate amount calories to cut per day to lose weight

A

500 - 750 kcal

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12
Q

Specific ways to increase adherence/interventions and counseling to use

A
  • onsite programs with trained professional

- encourage pts to BUILD UP exercise (up to 5 days a week of 30 minutes)

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13
Q

Criteria for bariatric surgery

A

BMI over 40 AND BMI over 35 + coexisting conditions AND motivated to lose weight AND has not responded to behavioral treatment (with or without pharmacotherapy)

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14
Q

Effects of bariatric surgery

A
  • reduce calorie intake

- ensure behavior modification through eating small amounts of food slowly and throughly chewing each mouthful

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15
Q

Average weight loss with bariatric surgery = ___ %

A

50% of body weight

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16
Q

5 classes of drugs for Prescription drug therapy options - LONG TERM

A
  • Lipase inhibitor
  • Serotonin 5-HTC2 receptor agonist
  • Symphathomimetic (CNS STIMULANT) and anticonvulsant
  • opioid antagonist/dopamine and norepinepherine reuptake inhibitor
  • GLP-1 agonist
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17
Q

Class of prescription drug that is for short term use for weight loss

A

CNS stimulants

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18
Q

Lipase inhibitor weight loss drug

A

Orlistat - Xenical or Alli

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19
Q

Orlistat is generic for ?

A

Xenical or Alli

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20
Q

Orlistat is apart of what kind of drug class

A

lipase inhibitor

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21
Q

Lorcaserin is generic for ?

A

Belviq

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22
Q

Belviq is apart of what kind of drug class

A

serotonin 5-HT2C Receptor agonist

23
Q

Qsymia is brand for what?

A

Phentermine and topiramate

24
Q

Qsymia is apart of what kind of drug class

A

sympathomimetic and anticonvulsant

25
Contrave is brand for what?
Naltrexone and bupropion extended release
26
Contrave is apart of what kind of drug class
opioid antagonist and dopamine/norepinephrine reuptake inhibitor
27
Saxenda is brand for ?
liraglutide
28
Saxenda is apart of what drug class
GLP-1 agonist
29
BMI equation
Kg/ m^2 or lbs/in^2 x 703
30
BMI ranges (for underweight, normal weight, overweight, obese)
under: < 18.5 normal: 18.5 - 24.5 over: 25 - 29.9 obese: over 30
31
Waist circumfrences for females and males that indicate they are at a higher risk for issues
female if over 35 INCHES male if over 40 INCHES (dont forget to convert to cm if relevant)
32
Potential complications from bariatric surgery
wound infections; GI leaks; DVT; depression; cholecystitis; fractures; vitamin deficiencies
33
Mechanism or Orlistat
reversibly inhibits gastric and pancreatic enzymes - lipids (long chain TGs) not absorbed!
34
Dosing of Xenical and Alli
Xenical - 120 mg TID Alli - 60 mg TID (Take within 1 hr of eating a fat-containg meal - dont take if you didnt eat)
35
Contraindications (other than pregnancy): for Orlistat
cholestatis; chronic malabsorption syndrome
36
Drug interactions with Orlistat
Levothyroxine; Warfarin (bc Vit.K); Cyclosporine; Multivitamins (bc fat soluble vitamins); Oral contraceptives (if lots of side effects of diarrhea)
37
Common Side effects of Orlistat
Oily spotting, abdominal pain/discomfort, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, defecation increased
38
Mechanism of action for Belviq (Lorcaserin)
will ACTIVATE serotonin-5HT2C in the hypothalamus to result in satiety/decreased food intake
39
Dosing of Belviq (Lorcaserin)
10 mg BID OR 20 mg QD (if Belviq XR)
40
Which drug is allowed by FDA for kids over 12 years old
Xenical - Rx only
41
Which drug is contraindicated with patients that have glaucoma
Qsymia - phentermine/topiramate and (Contrave - may cause narrow angle glaucoma - do not use either!!!)
42
Which weight loss drugs should not be used in patients with alcoholism or addictoin
Contrave - the bupropion part will lower seizure threshold
43
Which weight loss drugs can breastfeeding mothers use?
NONE - none recommended at all
44
Which weight loss drug should not be used by opioid users
Contrave - bc naltrexone component
45
Which drug should not be used by patients with a history of pancreatitis
Saxenda/ liraglutide
46
Which weight loss drug should patients with hypertension avoid
Contrave - (because of uncontrolled hypertension)
47
Which weight loss drugs can type 2 diabetics use?
All of them are ok!
48
Which weight loss drugs can SEVERE hepatic impairment patients use?
NONE - all bad for them | if just mild - to moderate impairment - use all with caution
49
Which weight loss drug should patients with seizure disorders avoid?
Contrave - because of bupropion portion
50
Which weight loss drug should not be used in patients with a history of thyroid cancer
Saxenda
51
Common adverse reactions with Saxenda
irritation at injection site and HYPOGLYCEMIA and GI effects
52
Mechanism of Saxenda
it is GLP-1 agonist - reduction of food intake/SLOWS gastric emptying
53
Main contraindications with Contrave
- opioid use or other bupropion use - uncontroleld HTN - seizure disorder
54
Dosing of Contrave and "how" to take it
- titrate up to 2 AM and 2 PM | - do NOT with a high fat meal

Therapeutics I - Spring 2017 (17 decks)

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