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RxPrep
Weight loss (CH57)
| Question | Answer |
|---|---|
| What is the typical weight loss goal? | 5–10% of total body weight in 6 months |
| When are antiobesity medications indicated? | BMI ≥30 OR BMI ≥27 with comorbidity |
| When should antiobesity meds be discontinued? | If <5% weight loss after ~12 weeks |
| BMI for obesity? | Usually >30 >25 in asian patients |
| Lifestyle recommendations for obesity? | ≥150 minutes/week Low-calorie, low-carb/fat, high protein |
| What condition should be evaluated before treating obesity? | Hypothyroidism or other diseases |
| Which antiepileptics cause weight gain? | Valproate, gabapentin, pregabalin |
| Which diabetes drugs cause weight gain? | Insulin, sulfonylureas, meglitinides, TZDs |
| Which antidepressants cause weight gain? | Mirtazapine, TCAs |
| Which antipsychotics cause weight gain? | Clozapine, olanzapine, risperidone, quetiapine |
| Which mood stabilizer causes weight gain? | Lithium |
| Which HIV drugs cause weight gain? | Integrase inhibitors (INSTIs) (e.g., dolutegravir) |
| Which steroid class causes weight gain? | Systemic steroids (prednisone) |
| What drugs can cause weight loss? | Topiramate, GLP-1s, bupropion, ADHD stimulants, PDE inhibitors (eg roflumilast or apremilast) |
| GLP-1 boxed warnings and major ADRs? | Box warning: Thyroid C-cell tumors Pancreatitis, gallbladder diseasse |
| GLP-1 contraindications? | MTC or MEN2 (multiple endocrine neoplasia) history |
| Why do GLP-1s need to be stopped before surgery? | Risk of aspiration due to slower gastric emptying |
| GLP-1 monitoring? | GI tolerance, hypoglycemia if on insulin |
| Tirzepatide interaction? | May alter absorption of oral drugs |
| What is orlistat brand? | Xenical or Alli |
| Orlistat MOA? | ↓ fat absorption (~30%) |
| Orlistat ADRs and warnings? | Fatty/oily stools, fecal urgency Can cause malabsorption, liver damage, kidney stones |
| What vitamins must be supplemented with orlistat? | A, D, E, K (fat soluble vitamins), but separate by 2+ hours |
| Phentermine use duration? | <12 weeks |
| Phentermine contraindications? | CVD, hyperthyroidism, glaucoma, MAOI use |
| What is phentermine/topiramate brand? | Qsymia |
| Risks of Qsymia? | Suicidal thoughts, acidosis, teratogenic Needs REMS |
| Counseling for Qysmia? | Take in the morning |
| CIs for Qsymia? | Gluacoma, hyperthyroid, MAOI use |
| What is brand for naltrexone/bupropion? | Contrave |
| Boxed warning for contrave? | Suicidal thoughts (due to bupropion) |
| Contraindications for Contrave? | Seizure disorder, opioid use, MAOI use Uncontrolled hypertension |
| Major ADRs of Contrave? | Dry mouth, insomnia, constipation |
| Counseling for Contrave? | Avoid opioids while taking it, can cause withdrawel |
| When is bariatric surgery indicated? | BMI ≥35 OR BMI ≥30 with T2DM or failed therapy |
| What is the mechanism of bariatric surgery? | Restricts intake ± malabsorption |
| Common deficiency after surgery? | B12, iron, and fat soluble vitamins (A, D, E, K) |
| Perferred Ca supplement after bariatric surgery? | Calcium citrate |
| Why do we need Ca supplementation after bariatric surgery? | For patients with reduced stomach capacity. It prevents bone loss, osteoporosis, and secondary hyperparathyroidism by supplying essential calcium |
| Complications of bariatric surgery? | Gallstones and malabsoprtion of current medications |
| Drug used for gallstones? | Ursodiol |
| How long can bariatric surgery patients need altered medication fromulations after the procedure? | 2 months |
Created by:
cdaughtry