Obesity

Question 1

Leptin

Answer 1

Adipokine
- Reduces AMPK signals
–> Suppresses appetite

Question 2

Liraglutide

Answer 2

GLP-1R Agonist (Gs = Increased cAMP)
- Reduces Appetite

• Type 2 Diabetes: 1.8 mg
• Obesity: 3.0 mg

Question 3

Semaglutide

Answer 3

New GLP-1R Agonist (Gs = Increased cAMP)
- Reduces Appetite

• Type 2 Diabetes: 1.0 mg
• Obesity: 2.4 mg

Question 4

Orlistat

Answer 4

Lipase Inhibitor
- Inhibits the breakdown of fat so that it is not absorbed

Question 5

Lorcaserin

Answer 5

Selective 5-HT2C Receptor Agonist
- Increase POMC = Decreased Appetite

10 mg twice daily
or
20 mg (extended release) once daily

Question 6

Phentermine/Topiramate

Answer 6

Phentermine: Sympathomimetic Amine
- Amine Receptor Agonist

Topiramate: Anticonvulsant Agent
- Acts on Na+/Ca2+ –> Inhibits Carbonic Anhydrase

Dose:
- 3.75 / 23
- 7.5 / 46
- 11.25 / 69
- 15 / 52

3.75x / 23y

Question 7

Topiramate

Answer 7

Topiramate: Anticonvulsant Agent
- Acts on Na+/Ca2+ –> Inhibits Carbonic Anhydrase

Monotherapy can decrease appetite in binge eating

Combination Therapy with Phentermine
- Reduces Body Weight

Question 8

Bupropion/Naltrexone

Answer 8

Bupropion: NA/DA Reuptake Inhibitor
- Treats depression
- Metabolite (Hydroxybupropion) can antagonize nicotinic acetylcholine receptors

Naltrexone: Competitive Opioid Receptor Antagonist
- Mu and K Opioid Receptor Antagonist

Together they modify the reward pathway to reduce appetite

Week 1: 8 mg / 90 mg
Week 2: 16 mg / 180 mg
Week 3: 24 mg / 270 mg
Week 4: 32 mg / 360 mg

Question 9

Tirzepatide

Answer 9

Unimolecular Co-Agonist
- GLP-1 Receptor Agonist
- GIP Receptor Agonist

Greater weight loss than just a mono GLP-1 agonist

Question 10

Retatrutide

Answer 10

Triple Agonist
- GLP-1 Receptor Agonist
- GIP Receptor Agonist
- Glucagon Receptor Agonist

Makes co-agonist better
Glucagon increases energy expenditure