RxPrep Weight Loss

25-29.9

The range for overweight BMI is ________ kg/m^2.

≥30

The range for obesity BMI is ________ kg/m^2.

coronary heart disease, HTN, stroke, type 2 diabetes

A person who's overweight is at a higher risk for what 4 diseases?

decreased; increased

Calories must be (decreased/increased) and/or energy expenditure (decreased/increased) to force the body to use fat as an energy source in order to lose weight.

satiety

Many weight loss drugs work by increased ________.

antipsychotics, diabetes drugs, divalproex/valproic acid, gabepentin, lithium, mirtazapine, pregabalin, steroids, tricyclic antidepressants

What are 9 drugs/classes that can cause weight gain?

clozapine, olanzapine, risperidone, quetiapine

(ROC is a Chunk)

What are 4 antipsychotics that commonly cause weight gain?

insulin, meglitinides, sulfonylureas, thiazolidinediones

What are 4 diabetes drugs/classes that commonly cause weight gain?

amitriptyline, nortriptyline

What are 2 tricyclic antidepressants that commonly cause weight gain?

hypothyroidism

What condition commonly causes weight gain?

≥150; 3-5

When trying to lose weight, physical activity should increase to ________ minutes per week, performed on ________ separate days.

bitter orange; caffeine

OTC weight loss supplements commonly contain stimulants, such as ________, and/or excessive amounts of ________.

green tea powder, guarana

What are 2 alternative names caffeine can be packaged under?

true

True or False: Prescription weight loss drugs are not appropriate for patients with small amounts of weight to lose.

≥30; ≥27

Prescription weight loss drugs are indicated with a BMI of ________ kg/m^2, or a BMI of ________ kg/m^2 with at least one weight-related condition.

false (in combination with dietary plan and increased physical activity)

True or False: Prescription weight loss medications are used alone in order to lose weight.

Contrave, orlistat, Qsymia, Saxenda, Wegovy

What 5 newer prescription weight loss drugs can be continued long-term for weight maintenance?

5; 12 weeks

Prescription weight loss drugs should be discontinued if they don't produce at least a(n) ________% weight loss at ________ of therapy.

ADHD drugs, bupropion, GLP-1 agonists, pramlintide, roflumilast, SGLT2 inhibitors, tirzepatide, topiramate

What are 8 drugs/classes that can cause weight loss?

amphetamine, methylphenidate

What are 2 ADHD drugs that can cause weight loss?

exenatide, liraglutide

What are 2 GLP-1 agonists that can cause weight loss?

canagliflozin, empagliflozin

What are 2 SGLT2 inhibitors that can cause weight loss?

celiac disease, hyperthyroidism, inflammatory bowel disease

What are 3 conditions that can cause weight loss?

true

True or False: All weight loss drugs should be avoided in pregnancy.

Contrave

What weight loss drug should be avoided in patients with hypertension?

Qsymia

What weight loss drug should be used with caution in patients with hypertension?

Contrave

What weight loss drug should be used with caution in patients with depression?

Contrave

What weight loss drug should be avoided in patients with seizures?

Qsymia

What weight loss drug should be used with caution in patients with seizures?

Contrave

What weight loss drug should be avoided in patients taking opioids?

phentermine

sympathomimetic (stimulant) used for weight loss; release of norepinephrine stimulates the satiety center which decreases appetite

topiramate

drug that increases satiety and decreases appetite, possibly by increasing GABA, blocking glutamate receptors, and/or inhibition of carbonic anhydrase

Qsymia

What weight loss drug is a part of a REMS program due to teratogenic risk?

glaucoma, pregnancy

What are 2 contraindications for Qsymia?

insomnia, tachycardia, vision problems

What are 3 side effects of Qsymia?

Qsymia

Which weight loss drug should be tapered off when discontinuing due to seizure risk?

food cravings

When used for weight loss, naltrexone in combination products decreases ________.

appetite

When used for weight loss, bupropion in combination products decreases ________.

MAO inhibitor use, opioid use, pregnancy, seizure disorder, uncontrolled HTN

What are 5 contraindications for Contrave?

psychiatric

Contrave should be used with caution in patients with ________ disorders.

opioids

Naltrexone blocks ________.

increase satiety

How do GLP-1 agonists work to promote weight loss?

Saxenda

What is the brand name for the liraglutide formulation approved for weight loss?

Victoza

What is the brand name for the liraglutide formulation approved for diabetes?

subcutaneous

What route of administration is used for GLP-1 agonists for weight loss?

Wegovy

What is the brand name for the semaglutide formulation approved for weight loss?

Ozempic

What is the brand name for the semaglutide formulation approved for diabetes?

pregnancy

What is a contraindication for Saxenda?

hypoglycemia, pancreatitis

What are 2 warnings associated with GLP-1 agonists?

nausea

What is a side effect associated with GLP-1 agonists?

lipase inhibitor

drug class used in weight loss that decreases the absorption of dietary fats by ~30%

lipase inhibitor

Orlistat is an example of a(n) ________.

Xenical

What is the brand name for prescription orlistat?

Alli

What is the brand name for OTC orlistat?

low-fat

Orlistat must be used with a(n) ________ diet plan.

pregnancy

What is a contraindication for orlistat?

fatty stool, flatus w/ discharge

What are 2 side effects associated with orlistat?

A, D, E, K, beta carotene

When taking orlistat, multivitamins containing what 5 things should be taken at bedtime or separated by ≥2 hours?

30

When taking orlistat, a max of ________% of kcals should come from fat.

Adipex-P

What is the brand name for phentermine?

CV disease, drug abuse, glaucoma, hyperthyroidism, pregnancy, uncontrolled HTN

What are 6 contraindications for phentermine?

agitation, increased BP, tachycardia

What are 3 side effects associated with phentermine?

BP, HR

What are 2 monitoring parameters for phentermine?

short; 12 weeks

Phentermine should only be used (long/short)-term, up to ________.

≥40; ≥35

Guidelines recommend weight loss or bariatric surgery for adults with a BMI of ________ kg/m^2 or with a BMI of ________ kg/m^2 with an obesity-related condition.

calcium citrate

________ is the preferred calcium supplementation after bariatric surgery as it has non-acid-dependent absorption.

iron, vitamin B12

Anemia can result from ________ and ________ deficiency, so both may require supplementation after bariatric surgery.

2 hours; 4 hours

Iron and calcium supplements should be taken ________ prior to or ________ after antacids.

fat

Patients may require life-long supplementation of the (fat/water)-soluble vitamins after bariatric surgery due to malabsorption.

A, D, E, K

What are the fat soluble vitamins?

2 months

Medications may require dose reduction and may need to be crushed and put in liquid or used in transdermal formulations for up to ________ after bariatric surgery.

ursodiol

What drug is used to dissolve gallstones formed after rapid weight loss?