Home' Australian Pharmacist : Australian Pharmacist January 2015 Contents Australian Pharmacist January 2015 I © Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
1. Unexplained weight loss can be
a) Advanced heart failure – due to muscle
and fat wasting.
b) Cancer – due to the decrease in
production of cytokines.
c) Hyperthyroidism – due to a decreased
d) COPD – due to a reduction in overall
daily energy expenditure.
2. Side effects of medicines which can
contribute to un explained weight
3. Dementia can be associated with
unexplained weight loss due to:
a) Hypermetabolism which can affect
b) Pituitary dysfunction leading to appetite
c) Elevated levels of TNF-alpha.
d) Mesial temporal cortex atrophy
affecting the control of feeding.
4. When treating unexplained weight
loss, non-pharmacological strategies
a) Low energy meal supplements.
b) Eating larger meals less often.
c) Improvement of oral health.
d) Avoidance of soft textured foods.
5. When assessing unexplained weight
a) In patients who are frail and elderly,
weight loss of more than 3% of body
weight may be associated with
b) Nutritional assessments are rarely used.
c) Opinion of family and friends (to verify
weight loss) is not considered by the
d) For middle-aged adults, weight loss
of more than 3% of body weight is
Six weeks later, Mrs Johnson returns
to the pharmacy to purchase a gift for
her daughter’s birthday. She informs
you that her doctor diagnosed her
with Alzheimer’s disease and referred
her to a psychiatrist who prescribed
Aricept (donepezil) 5 mg once daily.
She is under the close watch of her
psychiatrist, who has been assessing her
symptoms fortnightly. She has noticed
a small increase in her appetite, and is
visiting a dietitian once a week to try
and improve her diet. She is pleased to
inform you that she has gained a small
amount of weight already. Mrs Johnson
thanks you for prompting her to speak
to her doctor about her symptoms, and
she is still able to stay in her own home
at the moment, as her condition is being
treated, and her family are helping her
to deal with this new diagnosis.
1. Wong C. Involuntary weight loss. Med Clin N Am
2. Anker S, Sharma R. The syndrome of cardiac cachexia. Int J
Cardiol 2002;85:51–66 .
3. Dale J, Daykin J, Holder R, Sheppard M, Franklyn J. Weight
gain following treatment of hyperthyroidism. Clin
Endocrinol 2001;55:233–9 .
4. Ramakrishnan K, Salinas R. Peptic ulcer disease. Am Fam
5. Malfertheiner P, Chan F, McColl K. Peptic ulcer disease.
6. Alibhai S, Greenwood C, Payette H. An approach to the
management of unintentional weight loss in elderly
people. CMAJ 2005;172(6):773–80 .
7. Douglass R, Heckman G. Drug-related taste disturbance.
Can Fam Physician 2010;56(11):1142–7.
8. Huffman G. Evaluating and treating unintentional weight
loss in the elderly. Am Fam Phys 2002;65(4):640–50.
9. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2014. At: www.amh.net.
10. Stajkovic S, Aitken E, Holroyd-Leduc J. Unintentional
weight loss in older adults. CMAJ 2011;183(4):443–9 .
11. Elovainio M, Shipley M, Ferrie J, et al. Obesity, unexplained
weight loss and suicide: the original whitehall study. J
Affect Disord 2009;116:218–21.
12. Mayo clinic. Depression (major depressive disorder). 2014.
13. Berry J, Baum C. Reversal of chronic obstructive pulmonary
disease-associated weight loss. Drugs 2004;64(10):1041–52 .
14. Ezzell L, Jensen G. Malnutrition in chronic obstructive
pulmonary disease. Am J Clin Nutr 2000;72:1415–6 .
15. Albanese E, Taylor C, Siervo M, et al. Dementia severity and
weight loss: a comparison across eight cohorts. The 10/66
study. Alzheimers Dement 2013;9:649–56.
16. Gillete-Guyonnet S, Nourhashemi F, Andrieu S, et
al. Weight loss in Alzheimer disease. Am J Clin Nutr
17. Miyamoto K, Higashino S, Mochizuki K, et al. Evaluation
of weight loss in the community-dwelling elderly with
dementia as assessed by eating behavior and mental
status. Asia Pac J Clin Nutr 2011;20(1):9–13
KEY LEARNING POINTS
Unexplained weight loss is a common
condition in the elderly. There are
a range of potential causes, and it
is essential that pharmacists take
a detailed patient history to be
able to determine the most likely
Treatment is directed primarily towards
non-pharmacological strategies and
referral where appropriate for the
treatment of any underlying condition
Links Archive Australian Pharmacist December 2014 Australian Pharmacist February 2015 Navigation Previous Page Next Page