Anti-Obesity Agents Flashcards
which artificial sweetener is 300-fold sweeter than sucrose and caused bladder cancer in rats due to micro-crystals which do not develop in humans?
Saccharin
which artificial sweetener is 30-50 fold sweeter than sucrose and was banned by the FDA due to concerns over bladder cancer?
Cyclamate
which artificial sweetener is 200-fold sweeter than sucrose and is a methylated dipeptide?
Aspartame
which artificial sweetener has a phenylalanine metabolite that can harm pts with phenylketouria?
Aspartame
which which artificial sweetener is 7,000-13,000 fold sweeter than sucrose and is not used in foods and has negligible effect on PKU pts?
Neotame
which artificial sweetener is 200-fold sweeter than sucrose, is not metabolized, is used in beverages, and is combined with other sweeteners due to bitter aftertaste?
Acesulfame-K
which artificial sweetener is 600-fold sweeter than sucrose and is a chlorinated derivative of sucrose?
Sucralose (splenda)
which artificial sweetener is 200-fold sweeter than sucrose and has two different formulations depending on the number of methyl groups attached to glucose on the structure?
Stevia
which artificial sweetener is the same sweetness as glucose, but 40% fewer calories and is a polyol structure?
Xylitol
what drug is labeled as a fatty acid substitution that has a structure of sucrose esterified with stearic acid?
Olestra
which drug can cause hypovitaminosis and why?
Olestra because fat soluble vitamins need fat to be properly absorbed
What drug is an irreversible inhibitor of pancreatic lipase?
Orlistat
what anti-obesity drug has interactions with cyclosporine, levothyroxine, warfarin, and fat soluble vitamins?
Orlistat
what are the 2 brand names for Orlistat?
why does it not have systemic SEs?
what SEs does it have?
what is the dosing?
Alli and Xenical
it is not absorbed
GI-related: oily stools, cramps and flatulence
Alli: 60mg tid with fat-containing meals
Xenical: 120mg tid with fat-containing meals
Anorexiants are only used for people with a BMI over?
Length of therapy should be?
30
less than 12 weeks, and not to exceed 6 months
Which drug is a schedule IV that with continued use can lead to tolerance and rebound weight gain?
Phentermine
What drug is phentermine combined with?
Topiramate
what drug was withdrawn from the market due to concerns over heart valve disease?
Fenfluramine
what is the MoA of Sibutramine?
why was it withdrawn?
inhibit NT reuptake and stimulation of thermogenesis by activating B3 in adipose tissue
concerns of CVD
why was Lorcaserin removed from the market?
increased risk of cancer
what is the name of the first CB1 receptor blocker?
why was it removed from market?
Rimonabant
concerns of increased risk of suicide
what are the functions of GLP-1 receptor agonists?
increase insulin secretion
inhibit gastric acid secretion and emptying
increase satiety by acting on CNS
Liraglutide:
how was it formulated to be long-acting?
The lysine attached to liraglutide had palmitic acid attached to it using a Glutamine in between
which GLP-1 is not yet approved for obesity?
Exenatide
what is the brand name of Semaglutide that is approved for obesity?
How is it dosed and why?
Wegovy
once weekly due it it’s longer half-life
which drug had a BBW for increased risk of toe and foot amputations that was removed in 2020?
Canagliflozin
what is Xigduo XR?
a combo product of dapagliflozin and metformin
what is the MoA of 2,4-Dinitrophenol?
causes energy from B-oxidation to be converted to heat instead of ATP… NEVER APPROVED
what is Dr. Stevens proposed drug that induces thermogenesis?
Xanthohumol Pyrazole Derivative
pts with uncontrolled HPT or history of heart disease should not use which two meds?
phentermine and diethylpropion
pts w/ T2DM who are overweight should be prescribed what drug classes for weight loss in addition to metformin?
GLP-1 and SGLT-2 inhibitors
women overweight with comorbidities who need contraception should use what kind?
oral
what drug class should be avoided in pts with chronic inflammatory diseases due to causing weight gain?
corticosteroids
what are drug-induced causes of obesity?
TCAs
oral contraceptives
antipsychs
anticonvulsants
glucocorticoids
sulfonylureas
glitazones
B blockers
what defect of the thyroid can cause weight gain?
hypothyroidism
if a med shows weight loss of less than ____ after 3 months, it should be discontinued
5%
ziprasidone causes ____ weight gain compared to olanzapine
less
which anti-epileptic drugs are associated with weight loss?
felbamate
topiramate
zonisamide
which anti-epileptic drugs are associated with weight gain?
gabapentin
pregabalin
valproic acid
vigabatrin
carbamazepine
which anti-epileptic drugs are weight-neutral?
lamotrigine
levetiracetam
phenytoin
valproic acid has shown to cause weight _____
gain
which drug is the most commonly prescribed drug for weight loss and is often used off label?
Phentermine
When is long term prescribing of phentermine considered reasonable?
-no evidence of CVD
-no psych disease or substance abuse
-pt aware that phentermine long term use is off label
-no significant increase in pulse or BP
-significant weight loss occurs
