Elevated waist circumference in men
>/= 40 in
Elevated waist circumference in women
>/= 35 in
Elevated TG level
>/= 150 mg/dL
Reduced LDL in women
<50 mg/dL
Reduced LDL in men
<40 mg/dL
Elevated BP reading
>/= 130/80 mmHg
Elevated FBG reading
>/= 100 mg/dL
How many measures does a patient need to meet to be diagnosed with metabolic syndrome
3 of 5
underweight BMI
<18.5
normal BMI
18.5 - 24.9
Overweight BMI
25-29.9
Obese class I
30-34.9
Obese class II
35-39.9
Obese class III
>/= 40
Elevated waist circumference in Asian men
>/= 33.5
Elevated waist circumference in Asian women
>/= 29-31.5
what BMI is indicated for weight loss surgery?
BMI >/= 40 or
BMI >/=35 and at least one or more severe obesity-related complications
Pharmacotherapy for overweight/obesity should be used only as an adjunct to lifestyle therapy and not alone?
True
BMI to prescribe weight loss meds?
BMI >/= 30 or
BMI >/= 27 with at least one or more severe obesity-related complications
What are the three short term agents
1. Phentermine
2. Phendimetrazine
3.Diethylpropion
ADE of phentermine
Increased BP
Insomnia
palpitations
arrhythmias
4 contraindications of phentermine
1. Hyperthyroidism
2. History of CV disease
3. Abusers of cocaine/meths
4. Use during or with MAOIs
Phentermine is a CIII?
False: CIV
Monitoring of short acting agents:
Baseline cardiac evaluation
ECG during therapy
BP
D/C if not weight loss in 4 weeks
Phentermine should be abruptly d/c'd?
False: may cause extreme fatigue and depression
ADE of Alli
soft stool, abdominal pain or colic, flatulence, fecal urgency
What should be monitored on Alli
thyroid and liver function
Which agent may need backup contraception?
Alli
Brand name of phentermine-topiramate
Qsymia
What agent must be titrated up?
Qsymia
ADE of Qsymia
Constipation, dry mouth, paresthesia, dysgeusia, insomnia, tachycardia
What should be monitored on Qsymia
HR, electrolytes, SCr, depression or suicidal thoughts, mood to sleep disorders
Three CI of Qsymia
1. Glaucoma
2. Untreated hyperthyroidism
3. Pregnancy
What agent has a REMS program for pregnancy?
Qsymia
What is the brand name for naltrexone-bupropion?
Contrave
ADE of naltrexone
hepatotoxicity
ADE of bupropion
suicidal ideation, activation of mania, angle-closure glaucoma
6 CI with Contrave
1. Seizure disorder
2. Bulimia/anorexia
3. Concurrent use of MAOIs
4. Chronic opioid use
5. Uncontrolled HTN
6. Abrupt withdrawal of chronic alcohol, BZDs, barbiturates, or anti epileptics
Which agent has DDIs with CYP2B6 inducers and CYP2D6 substrates and should not be taken with a high fat meal?
Contrave
Brand name of liraglutide
Saxenda
Target dose of saxenda
3 mg SQ QD
Target dose of wegovy
2.4 mg SQ weekly
How often should a patient be monitored while on weight loss therapy?
Monthly for the first three months
Then every 3 months thereafter