Obesity

Question 1

Obesity?

Answer 1

The term obesity is given to individuals with a body mass index (BMI)
≥ 30 kg/m2
* Obesity is due in part to an energy imbalance (calorie consumption
exceeds calorie expenditure)

Question 2

Sibutramine MOA?

Answer 2

Serotonin and NE re-uptake inhibitor

Question 3

Sibutramine CI?

Answer 3

Patients with poorly controlled history of coronary artery disease

CHF

Arrhthmia

Stroke

Regular BP and heart rate monitoring required

Patients with SSRI

Question 4

Orlistat(Xenical) MOA?

Answer 4

Inhibits gastric and pancreatic lipases.

Question 5

Orlistat(Xenical) Site of action?

Answer 5

Activity occurs in the stomach and small intestine

Question 6

Orlistat(Xenical) to minimise S/E?

Answer 6

Low-fat diet (≤ 30%) required to minimize side effects.

Question 7

Orlistat(Xenical) Prescribing information?

Answer 7

120 mg TID with meals containing fat.
* Patients should be on a nutritionally balanced, low-fat
diet (< 30%) to minimize side effects.
* Prescribe multivitamin to be taken at least two hours
before or after the medication.

Question 8

Orlistat(Xenical) CI?

Answer 8

Orlistat is contraindicated for pregnant or lactating
women, and those with chronic malabsorption
syndromes or cholestasis.

Question 9

Anorexiants (Appetite Suppressants) Drugs?

Answer 9

oDiethylpropion
oPhentermine

Question 10

Anorexiants (Appetite Suppressants) MOA?

Answer 10

↑ the release of NE and DA from the nerve terminals,
and by inhibiting reuptake of these neurotransmiƩers → ↑ levels of
NE and DA in the brain

Question 11

When is Anorexiants (Appetite Suppressants) discontinued?

Answer 11

Tolerance to the weight loss effect develops within weeks (plateaus)
* ↑ in the dosage generally does not result in further weight loss, and
discontinuation of the drug is usually recommended once the plateau
is reached

Question 12

Anorexiants (Appetite Suppressants) S/E?

Answer 12

• S/E: Dry mouth, headache, insomnia, consƟpaƟon, ↑ HR and BP
• All Anorexiants are classified as controlled substances

Question 13

Lipase Inhibitors Drugs?

Answer 13

oOrlistat

Question 14

Lipase Inhibitors MOA?

Answer 14

Indicated for weight loss or weight maintenance
* Inhibits gastric and pancreatic lipases → ↓ breakdown of dietary fat
and fat ↓ absorption by about 30% (loss of calories)

Question 15

Lipase Inhibitors S/E?

Answer 15

S/E: GI (oily spotting, flatulence with discharge, faecal urgency, and
frequent defecation)
* Severe S/E: Pancreatitis

Question 16

Lipase Inhibitors CI?

Answer 16

pregnancy and malabsorption syndrome

Question 17

Combination Drugs?

Answer 17

Phentermine and Topiramate approved for long‐term use in obesity

Question 18

Why is Phentermine and Topiramate combined?

Answer 18

Topiramate: anticonvulsant
* Because of sedative effects of Topiramate, the stimulant
Phentermine was added to counteract the sedation and promote
additional weight loss

Question 19

When should these combination drugs be discontinued ?

Answer 19

If a patient does not lose ≈ 5% of their body weight after 12 weeks of use, the drug should be discontinued

Question 20

Combination Drugs S/E?

Answer 20

• S/E: parasthaesias, suicidal ideation, cognitive dysfunction, kidney
  stones

Question 21

Combination Drugs CI?

Answer 21

• C/I: pregnancy (birth defects; cleft palate)

Question 22

Serotonin Agonists?

Answer 22

• Lorcaserin

Question 23

Lorcaserin MOA?

Answer 23

• Selective serotonin 2C (5‐HT2C) receptor agonist, causing ↓ in appetite

Question 24

Lorcaserin Discontinuation?

Answer 24

• Indicated for chronic weight management
• If a patient does not lose ≈ 5% of their body weight after 12 weeks of
  use, the drug should be discontinued

Question 25

Lorcaserin S/E?

Answer 25

• S/E: headache, dry mouth, dizziness, constipation, and suicidal ideation
• Severe S/E: serotonin syndrome

Question 26

Lorcaserin DI?

Answer 26

• Drug‐interaction: SSRIs, SNRIs, TCA, MAO‐I

Question 27

Lorcaserin CI

Answer 27

• C/I: heart diseases, renal

Answer 28

l