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clinical questions -
#1
intheend

hi everyone, i have some clinically oriented question if someone can help....

1. what would be the therapy for an 45 yr old obese female wanting to lose weight and also has osteoarthritis
2. how would you treat a 23 yr old female with suffering bulimia for last 3 yrs

thanks...
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#2
---

For obesity w/ arthritis
1. low cal diet low fat low CHO
2. smaller portions daily
3. swimming
4. walk 15 mins a day as tolerated
5. nsaid 30 mins prior to exercise w/ food
6. behavior modification
7. appetite suppressants if not contraindicated
8. bariatric surgery if severely obese BMI>32
For eating d/o, SSRIs , counseling, gradual increase in Kcals.
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#3
raghad - raghadkareem

adding to OA Rx .. Chondrotine sulfate
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#4
thorn

how about giving cypro heptadine to the bulemia patient!! i m not sure but this drug is notorius for its side effect of increased appetite!!
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#5
sjs

for bulimia, psychiatric treatment is main therapy, including of cognitive and behaviour therapies.
as a pharmacological drug given is SSRI.

to thorn
(BTW, cyproheptadine 5HT2 antagonist is mainly used for carcinoid syn and post gastrectomy dumping syndrome)
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#6
nani

just to add....cyproheptadina is also used in anorexia..
bulimia is trated, as sjs said, with behaviour therapies and SSRI (selective serotonin reuptake inhibitors)
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