Obesity drugs Flashcards
Liraglutide
Acylated peptide
-GLP-1R agonist reducing feeding by increase cAMP
—
-Type 2
-Obesity
—
-increased heart rate
-pancreatitis (not supported)
Leptin
Endogenous Adipokine
-induces satiety in hypothalamus
-binds C.1 cytokine receptor
—-
-only used for leptin deficient people
—
Lirglutide dose
1.8mg for type 2
3.0mg for obesity
0.6 weekly till 3mg max
Semaglutide
Newer peptide
-GLP-1R agonist reducing feeding by increase cAMP
—
-Type 2
-Obesity
—
-increased heart rate
-pancreatitis (not supported)
Semaglutide dose
1mg Q1W for type 2
2.4mg Q1W for obesity
titration in 1 month intervals
0.25, 0.5, 1.0, 1.7, 2.4
Orlistat
Lipase inhibitor
-binds serine AA in lipase reversibly inhibiting fat breakdown
—
-Obesity
—
-Low vitamins
-incontinence (oily poops)
-intestinal borborygmic
Orlistat dose
60mg OTC
120mg Rx TID
Phentermine/Topiramate
-sympathomimetic at trace amime associated receptor to increase dopamine to reduce feeding
-anticonvulsant (Na+/Ca+ inhibition, carbonic anhydrase inhibition
—
-obesity
—-
-insomnia (QAM)
-paresthesia (psychological itch)
-heart rate increase
-teratogeninc (topiramate)
-no MOA inhibitors
Phentermine/Topiramate dose
3.75/23 F14D
7/46 F1M
11.25/69 F1M
15/92 at max
Phentermine/Topiramate efficacy points
<3% loss on 11.25/69
<5% on second week of 15/92 (12 weeks)
Bupropion/Naltrexone
-NDRI, metabolites antagonize nicotinic acetylcholine receptors
-Competitive opioid receptor antagonist (mew/Kappa)
-both reduce reward pathway for feeding
—
-obesity
—
-increased heart rate and BP
Bupropion/ Naltrexone dose
16/360 or 32/360
1 tab QAM F1W
1 tab BID F1W
2 tab QAM 1 tab QHS F1w
2 tab BID at max
Tirzepatide
GLP-1R, GIP agonist
-reduce feeding and GIP does something
—
-obesity
Retatrutide
GLP-1R, GIP, Glucagon agonist
-glucagon helps increase energy use
-reduced feeding
—
-obesity
