Weight-Loss and Obesity Pharmacotherapy and Management

Comprehensive vocabulary flashcards covering the pathophysiology, surgical interventions, lifestyle modifications, and pharmacotherapy (including GLP-1 and dual incretins) for obesity and weight management.

What is a healthy BMI?

18.5-24.9

What is a overweight BMI?

25.29.9

What is a obese BMI?

>30

Which type of fat is more unhealthy?

Visceral fat

What is A type of adipose tissue primarily involved in energy storage and insulation, found throughout the body, and is less metabolically active?

White fat

What is a type of adipose tissue that is more metabolically active than white fat, helping to generate heat and burn calories?

Brown fat

What is the requirements for metabolic syndrome?

Elevated Blood sugar, BP, TGs, low HDL, large waste circumference

What is the diagnosis of Metabolic syndrome?

3 out of 5 present

What are some medications that causes obesity?

Anticonvulsants, Antidepressants, Antipsychotics, Antiretrovirals, Glucocorticoids, Progestins

What contributes to obesity?

Sugared drinks

What type of lifestyles changes help with obesity?

Counseling, diet, physical activity

What type of surgery is done to help with diabetes?

Bariatric surgery

What bariatric surgery is more restrictive than malabsorptive?

Adjustable Gastric Band

What bariatric surgery is Restrictive, somewhat malabsorptive?

Sleeve Gastrectomy

What bariatric surgery is Restrictive, malabsorptive?

Roux-en-Y Gastric Bypass

When is bariatric surgery indicated?

BMI > 40 without comorbidity illness or BMI 35-39.9 with comorbidity illness

What does absorption have an effect of medications after surgery?

Increase gastric pH, reduce bioavailabilty

What does Distribution have an effect of medications after surgery?

reduced volume distribution

What does Metabolism have an effect of medications after surgery?

Decreased cyp metabolism

What type of minerals or vitamines are given due to less absorption of minerals/vitamins?

Calcium, Vitamin D, Folate, Cyanocobalamin

What can bariatric surgery lead to deficiencies of?

thiamine, copper, zinc

What types of medications should be avoided after surgery?

Enteric coated, delayed release, extended-release formulations

What types of drugs should be AVOIDED after surgery?

DOACs, NSAIDS, corticosteroids, bisphosphonates

What should the BMI be to start weight-loss medication?

≥ 27 with a comorbidity

What type of comorbidities should a patient have to start medications for weight loss?

Hypertension, Dyslipidemia, Type 2 diabetes mellitus, Obstructive sleep apnea

What are short-term treatment?

Phentermine

What are long-term treatment?

Phentermine/topiramate, Naltrexone/bupropion, Orlistat, GLP1

When should weight-loss meds be avoided/contraindicated?

Pregnancy/breastfeeding

When should weight-loss meds be discontinued?

weight loss ≥ 5% of body weight not achieved in 12 weeks

How long is Phentermine approved for?

≤ 3 months

What is a contraindication of phentermine?

CVD

What are adverse effects of Phentermine?

Hypertension, dizziness, N/V/C, tremor

What is the CrCL where Phentermine/topiramate should not be used?

< 30

What drug should not be used if CrCl <30?

Phentermine/topiramate

What are adverse effects of Phentermine/topiramate?

Increased HR, CNS effect, kidney stones

What drug has contraindications of Glaucoma, hyperthyroidism, pregnancy, use of MAOI? GENERIC

Phentermine/topiramate

What drug has contraindications of Glaucoma, hyperthyroidism, pregnancy, use of MAOI? BRAND

Qsymia

What drug requires monthly pregnancy test due to being a category X? GENERIC

Phentermine/topiramate XR

What drug requires monthly pregnancy test due to being a category X? BRAND

Qsymia

What weight loss drug is dispensed by certified pharmacies? GENERIC

Phentermine/topiramate XR

What weight loss drug is dispensed by certified pharmacies? BRAND

Qsymia

What weight loss drug should be avoided with Alcohol and Carbonic anhydrase inhibitors? GENERIC

Phentermine/topiramate XR

What weight loss drug should be avoided with Alcohol and Carbonic anhydrase inhibitors? BRAND

Qsymia

What weight loss drug decreases the effect of Hormonal contraceptives? GENERIC

Phentermine/topiramate XR

What weight loss drug decreases the effect of Hormonal contraceptives? BRAND

Qsymia

What two drug classes may increase the risk of hypokalemia when taken with Phentermine/topiramate XR?

thiazide or loop diuretics

What two drug classes may increase the risk of hypokalemia when taken with Qsymia?

thiazide or loop diuretics

What drug needs monitoring of Weight, resting HR, Electrolytes / serum creatinine? GENERIC

Phentermine/topiramate XR

What drug needs monitoring of Weight, resting HR, Electrolytes / serum creatinine? BRAND

Qsymia

What drug has the BBW of Suicidality w/ antidepressant? GENERIC

Naltrexone/bupropion ER

What drug has the BBW of Suicidality w/ antidepressant? BRAND

Contrave

What drug has contraindications of Uncontrolled hypertension, Seizure disorders, Use of MAO-I? GENERIC

Naltrexone/bupropion ER

What drug has contraindications of Uncontrolled hypertension, Seizure disorders, Use of MAO-I? BRAND

Contrave

What drug should be avoided with alcohol due to lower seizure threshold? GENERIC

Naltrexone/bupropion ER

What drug should be avoided with alcohol due to lower seizure threshold? BRAND

Contrave

What drug should you not take with high-fat meal? GENERIC

Naltrexone/bupropion ER

What drug should you not take with high-fat meal? BRAND

Contrave

What drug has the contraindication of Chronic malabsorption syndrome, Cholestasis, and pregnancy? GENERIC

Orlistat

What drug has the contraindication of Chronic malabsorption syndrome, Cholestasis, and pregnancy? BRAND

Xenical

What drug has decreased fat-vitamin absorption, increased levels of urine oxalate, and GI effects? GENERIC

Orlistat

What drug has decreased fat-vitamin absorption, increased levels of urine oxalate, and GI effects? BRAND

Xenical

What drug should you not take if you skip meal or doesn’t contain fat? GENERIC

Orlistat

What drug should you not take if you skip meal or doesn’t contain fat? BRAND

Xenical

What drug should you take supplementation with multivitamin? GENERIC

Orlistat

What drug should you take supplementation with multivitamin? BRAND

Xenical

How many hours should you wait to take multivitamin when taking orlistat?

2 hours

What is the dosing for semaglutide?

0.25 every 4 weeks

What is the initial dosing for orforglipron?

0.8 mg

How often is orforglipron taken?

Once daily

What time of day can orforglipron be taken?

Whenever

What are DDIs with Orforglipron?

CYP3A4 inhibitors

What dose of simvastatin should not be exceeded when taking Orforglipron?

20 mg

What are common ADRs with GLP-1 & GLP1/GIP agonists?

N/V/D/C, hair loss, bloating

What age is semaglutide wegovy indicated for PO?

≥ 18

What age is semaglutide wegovy indicated for SQ?

≥ 12

What does semaglutide reduce the risk of?

Death, heart attack, stroke

What age is Tirzepatide indicated?

≥ 18

What age is orforglipron indicated for SQ?

≥ 18

Which drugs are recommended for modest weight loss?

Naltrexone-bupropion, Liraglutide, Phentermine, Orlistat

Which drugs are recommended for moderate weight loss?

Phentermine-topiramte

Which drugs are recommended for high weight loss?

Tirzepatide, Semaglutide