Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Tx of Obesity
Pharm-II
| Question | Answer |
|---|---|
| What patients are on insulin | almost all DMT2, and ~40%of DMT2 pts |
| When in the number of insulin pt’s supposed to double by | 2025 |
| What are the benefits of insulin | allow nl daily glycemic fluctuations that mimic physiological postprandial insulin levels, be affordable, flexible lifestyle, allow liberal food choices |
| How many BGC should be done/day | at least 3 depending on the DM and the control of it |
| 4 most important components in insulin dosing | BG levels, CHO/meal, Insulin dose, Activity level (Schedule and physical and emotional stress also come into play) |
| What insulin dose do we adjust | the one prior to the pattern seen |
| What has dramatically increased over the past 20 years | obesity |
| What is “Obesity” | BMI >30, >120% of ideal body wt, Waist Circum >40m, >35F |
| Underweights | BMI < 18.6 |
| Normal wt | BMI 18.5-24.9 |
| Overweight | BMI 25-29.9 |
| Obesity stage I | BMI 30-34.5 |
| Obesity Stage II | BMI 35-39.9 |
| Extreme obesity (III) | BMI >40 |
| What amount of wt reduction will reduce obesity-related health risks | Modest amount of 5-10% of wt |
| Some health risks associated w/ DM | DM, HTN, High lipids, CHD, Cancer, OA, Sleep apnea, preggo comps, Depression, Gallbladder dz, Gout, Hirsutism, Psych difficulties |
| What cancers are associated w/ obesity | Men: colorectal and prostate, Women: Endometrial, cervical, ovarian, breast, gallbladder |
| How to lose weight action | find a healthy weight, be active, eat well |
| PA recommendations | 30-60m most days of the week, limit TV time <2hr/day |
| Most important thing to remember when changing diet habits | select sensible portion sizes |
| 5 examples of public health responses to obesity | Families and communities w/ parks, schools, health care, media and communications, worksites |
| Goals of obesity tx | set realistic wt goals, appropriate rate, maintain lower body wt, prevent further wt gain |
| Two step processes in obesity tx | 1: assessment: measure what they r at, are they ready to change? 2: management |
| Management methods of DM | foods <30% fat, PA, change in behaviors, Pharm, surgery |
| When do we consider pharm tx for obesity | BMI > 30, or >27 w/ HTN, DM, hyper lipids |
| Problem w/ pharm tx | high incidence of wt gain post tx |
| What drug is approved for LT use | Orlistate (Xenical) |
| What is a reversible gastric and pancreatic lipase inhibitor and action | Orlistate (Xenical, Alli): ↓ dietary fat absorption by 30% |
| AE’s of orlistat | Oily or loose stools, fecal urgency, fecal incontinence, bloating and gas, which ↑ w/ ↑ fat intake |
| Problems w/ vitamin absorption | ↓ Vit D,E and B carotene |
| Rare serious cases with the use of orlistat | severe liver injury w/ hepatocellular necrosis |
| Drug interactions | ↑ bioavailability and lipid lowing effect of pravastatin |
| Efficacy for alli | >5% wt loss 45%, a >10% wt loss 20% |
| When do we dose alli | 120mg tid with each meal containing fat OTC is 60mg |
| What drug ↑NE and DA which is a mild CNS stimulant | Phentermine (lonamin or Fastin) |
| CI of Phentermine | severe HTN, symptomatic CV dz, Hyperthyroidism, glaucoma, concurrent MAIO, ETOH use |
| Precautions w/ phentermine | insulin requirements may ↓ w/ pts for DM CLOSE monitoring necessary |
| Why does insulin not needed for phentermine | ↓ appetite, ↓ food intake, ↓insulin need |
| Dose for phentermine | 30mg/day no added effect w/ higher dose |
| What is Diethypropion | another mild CNS stimulant |
| AE’s of diethrpropion | CNS stimulation: restlessness, insomnia, tremor, dizziness, HA, euphoria, dysphoria |
| DI’s w/ Diethypropion | do not use other CNS stimulants, and no MAOI w/I 14 days |
| CI of diehypropion | pulm HTN, artheriosclerisis, hyperthyroidism, glaucoma, severe HTN, MAOI ETOH use/abuse |
| What serious SE’s can this drug have | Sz’s in pts w/ sz d/o, limit dispensement d/t ↑ risk OD, insulin dose ↓ |
| What are two antidiabetic agents | Exendatide and Pramlintide use for wt loss |
| Herbal supplements for wt loss | none to be prescribed, |
| Why can herbal supplements be dangerous | many contain bitter orange: ↑ risk of CVA and cardioox |
| What does ↑ Ca++ do | SEEMS to ↑ wt reduction, LBM, and body fat loss |
| Problem w/ meal replacement prodcuts | when start eating again, gain it back |
| What will ↑ wt loss | ↓ caloric intake + PE |
| How do pts maintain wt loss | lifestyle changes: healthy food choices and physical activity |
| When do we consider pharm management for obesity | BMI >30 or >27 with co-morbitities CLOSE monitoring!! |
| Comorbitites that obesity can ↑ risk for | smoking, HTN, LDL >160 or >130 + 2 others, IFG, FHx, age and gender |
| What contributes to obesity | physical inactivity and ↑ serum TGs |
Created by:
becker15
Popular Pharmacology sets