Weight Loss Flashcards
(16 cards)
What BMI is considered overweight?
Which BMI is considered obese?
a person who is overweight has a higher risk for ?
BMI 25-29.9
BMI > 30
Coronary heart disease, HTN, stroke, T2DM
Which key drugs can cause weight gain?
A, D , D, G, P, L, M, S, T
Conditions such as : H
Other drugs:
B, D, H, M, S, V
Antipsychs (Clozapine, olanzapine, risperidone, quetiapine)
Diabetes drugs (insulin, SU’s, meglitinides, TZDs)
Divalproex/valproic acid
Gabapentin
Pregabalin
Lithium
Mirtazapine
Steroids
TCAs (amitriptyline, Notriptyline)
Hypothyroidism
beta blockers, dronabinol, hormones (estrogen, megestrol), MAOinhibitors, ssri’s (paroxetine), vasodilators (minoxidil)
Physical activity should incr to how many mins per week?
Performed on how many days?
> = 150 mins/week
3-5 separate days
OTC weight loss supps commonly contain stimulants such as? and/or excessive amounts of ___which can be packaged under diff names such as?
Bitter orange
caffeine
Guarana , concentrated green tea powder
Who are prescription drugs not appropriate for?
When are they indicated?
Weight loss medications are only used in addition to ?
Which newer weight loss meds can be continued long term?
when should weight loss drugs be discontinued?
Pt’s who have small amounts of weight to lose
BMI > 30, or a BMI > 27 with at least one weight related condition such as dyslipidemia, HTN, or diabetes
A dietary plan and incr physical activity
Qsymia, contrave, saxenda, wegovy, zepbound, orlistat
if they dont produce at least a 5% weight loss at 12 weeks
Select Drugs that can cause WEIGHT LOSS:
A, B, G, P, R, S, T, T
Conditions such as:
H, C, I
Others such as:
A, A, I, T
Conditions:
C, G or P, L, T
ADHD meds (amphet, methylphenidate)
Bupropion
GLP-1 agonists (exenatide, liraglutide)
Pramlintide
roflumilast
SGLT2I’s
Topiramate
Tirzepatide
Hyperthyroidism, celiac disease, IBD
Acetylcholinesterase inhibs (Donepezil, rivastigmine, galantamine)
antiseizure medications (zonisamide, ethosuximide)
Interferons
Thyroid drugs (levothyxorine)
Cystic fibrosis
GERD or PUD
Lupus
TB (active disease)
Prescription Weight Loss Drugs: Avoid or Use caution
- Pregnancy
- HTN
- Depression
- Seizures
- Taking Opioids
- avoid all weight loss drugs
- avoid contrave and stimulants (phentermine) - CI with uncontrolled BP
Caution: qsymia (monitor HR)
- Caution in young adults and adolescents
Contrave has suicide risk
- avoid Contrave , caution with qsymia (must taper off slowly)
- Avoid contrave
Phentermine is a ___
When combined with Topiramate in an ER formulation, whats the brand name?
Controlled substance?
REMS?
Contraindications? (2)
Side Effects? (3)
Can you abruptly dc it?
Sympathomimetic (stimulant)
Qsymia
C4
Yes REMS drug due to teratogenic risk
Pregnancy, glaucoma
Tachycardia, Insomnia (take in morn), vision problems
NO Taper off due to seizure risk
How do naltrexone and bupropion work to help with weight loss?
What is the brand name of the combo product?
Contraindications? (6)
Warnings: Use caution with ___
How does the naltrexone in this product precipitate withdrawal?
Naltrexone: Decr food cravings
Bupropion: Decr appetitie
Contrave
-Pregnancy
-Chronic opioid use
-uncontrolled HTN
-Seizure disorder
-Use of other bupropion containing products
-Use of MAOI within 14 days
psychiatric disorders
Naltrexone blocks opioids
GLP-1 Agonists:
- How they work to help with weight loss?
- Liraglutide
a. brand name?
b. how supplied?
c. Victoza is for ___ only
d. starting dose ? - Semaglutide
a. brand name for weight loss?
b. how supplied?
c. which form is for diabetes only?
d. starting dose?
- They incr satiety
- saxenda
b. injection
c. diabetes
d. 0.6 mg SQ DAILY x 1 week then titrate up
3a. wegovy
b. injection
c. ozempic and rybelsus
d. 0.25 mg SQ WEEKLY x 4 weeks
Dual GLP1 and GIP Agonist:
- how does it work to help with weight loss?
- Tirzepatide
a. brand name for weight loss?
b. how supplied?
c. which is the brand name for diabetes only?
- incr satiety
2a. zepbound
b. injection
c. mounjaro
GLP-1 Agonists and Dual GLP1 Agonists + GIP Agonists:
- Saxenda has a CI of ?
- Warnings of : (2)
- Not recc in pt’s with ?
- Side effects mainly?
- pregnancy
- pancreatitis, hypoglycemia
- severe GI disease, including gastroparesis
- nausea
Lipase Inhibitor:
- How does it work to help with weight loss?
- Orlistat
a. brand name of RX?
b. brand name of OTC?
c. MUST BE USED WITH? - Orlistat CI?
- Orlistat Side effects?
- Orlistat: should take ___ and ___ or separated by ___
- Whats the max amount of kcals from fat while on this drug?
- decr absorption of dietary fats by ~30%
2a. xenical
b. alli
c. low fat diet plan
- pregnancy
- GI (flatus with discharge), fatty stool
- MVI with vitamins ADEK and beta carotene at bedtime or separated by >= 2 hours
- max 30% of kcals from fat
Appetite Suppresants:
- How do they help with weight loss?
- Phentermine
a. brand name?
b. controlled substance? - Phentermine:
a. Contraindications/warnings?
-C___ such as ___ and ___
-H
-G
-P
-Hx of ___ - Phentermine:
a. side effects? (4) - Phentermine :
a. Monitoring ? (3) - How long is this used?
- Sympathomimetics (stimulants); release of NE stimulates the satiety center which decr appetite
2a. adipex-P or lomaira
b. C4
3a. Cardiovascular disease
-uncontrolled HTN, PULM HTN
-Hyperthyroidism
-Glaucoma
-Pregnancy
-Hx of drug abuse
- tachycardia
-agitation
-incr BP
-pulm htn - HR, BP, dyspnea
- Used short term for up to 12 weeks to jump start a diet
When do guidelines recc weight loss or bariatric surgery ? (3)
for BMI >= 35
for BMI >=30 and T2DM
for BMI >= 30 who CANNOT achieve or sustain a goal BMI or improvement in an obesity related comorbidity with other methods
Common Nutrient Deficiencies Bariatric Surgery :
- Calcium : Which form of calcium is preferred for supplementation?
- Anemia may result from?
- If a patient is taking antacids, which supplements should you separate them from and how long ?
- Patients may require life long supplementation of what?
- Medication concerns: Pt’s meds may need to be__ and put in ___ or used in ___ for up to how long after surgery?
- Due to bariatric surgery causing rapid weight loss, this can cause lots of gallstones. What med should be considered/needed?
- calcium citrate due to the fact that it has on acid dependent absorption
- Vit B12 and iron deficiency
- Iron and calcium supps should be taken 2 hrs prior or four hrs after antacids
- Fat soluble vitamins A, D, E, and K
- crushed, liquid, TD form, for up to 2 months post surgery
- Ursodiol
