TY - CHAP M1 - Book, Section TI - Eating Disorders A1 - Stoner, Steven C. A1 - Ruehter, Valerie L. A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael PY - 2017 T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - Patient Care Process for the Management of Eating DisordersCollectPatient characteristics (e.g., age, race, sex, pregnant)Patient history (past medical, family, social—dietary habits, exercise patterns, laxative use)Weight history and BMICurrent medications and prior eating disorder treatment(s)Objective dataBP, heart rate (HR), height, weight, and BMILabs (e.g., serum electrolytes, Scr, eGFR, BUN, metabolic panel)Other diagnostic tests when indicated (e.g., ECG, EEG, bone mineral density)AssessSymptoms of eating disorders (e.g., anorexia nervosa, bulimia nervosa, and binge-eating disorder) that may include poor body image, weight change, lethargy, binging, purging, GI complaints, etc.Presence of mental health conditions (e.g., depression, schizophrenia, anxiety disorders, etc.)Presence of medical conditions (e.g., malnourishment, cardiac arrhythmia, refeeding syndrome, metabolic acidosis and alkalosis, dehydration, GI complications, osteopenia, osteoporosis, dental problems, etc.)Laboratory abnormalities (e.g., hypokalemia, hypothyroidism, hypomagnesemia, hypophosphatemia, etc.)Current medications that may exacerbate eating disorder symptoms (e.g., diuretics, laxatives, etc.)For the type of eating disorder identified, assess the appropriateness of medication therapy (see Treatment section)Plan*Nonpharmacologic treatments (e.g., nutritional rehab, education, and counseling; cognitive behavioral therapy; interpersonal psychotherapy; dialectical behavior therapy, family and/or group therapy, etc.)Drug therapy dependent upon the eating disorder identified (e.g., antidepressants, antipsychotics, anticonvulsants, lisdexamfetamine, etc.) (see Figure 64-2)Monitoring parameters including efficacy (e.g., BP, cardiovascular events, kidney health), safety (medication-specific adverse effects), and timeframe Patient education (e.g., purpose of treatment, dietary and lifestyle modification, drug therapy)Self-monitoring of weight, BMI, BP, HR—where and how to record resultsReferrals to other providers when appropriate (e.g., physician, dietician)Implement*Provide patient education regarding all elements of treatment plan (nonpharmacologic and pharmacologic)Use motivational interviewing and coaching strategies to maximize adherenceSchedule follow-upFollow-up: Monitor and EvaluateDetermine changes in eating habits and compensatory behaviorsWeight, vital signs and laboratory valuesPsychiatric (mental status examination) and physical condition stabilityPatient adherence to treatment plan using multiple sources of information*Collaborate with patient, caregivers, and other health professionals SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1148575806 ER -