Obesity drugs

Question 0

Orlistat

Answer 0

GI lipase inhibitor (–l triglyceride breakdown & absorption)
Use: weight loss, OK for long-term use
SE: diarrhea, fecal incontinence, Vit A & E malabsorption

Question 1

Phentermine & Diethylpropion,

also: Phendimetrazine, Benzphetamine

Answer 1

NE anorectic (attenuated amphetamine)
--> increase NE => satiety effect on hypothalamus
Use: weight loss -- short term only!
SE: #1 = dependence, dry mouth, constipation, increased BP

Question 2

Exenatide

Answer 2

GLP-1 analog (incretin mimetic) via injection.
=> reduce appetite via CNS, slow gastric emptying
Use: approved for DM2 (but does cause weight loss)
SE: nausea

Question 3

Liraglutide

Answer 3

GLP-1 analog (incretin mimetic) via injection.
=> reduce appetite via CNS, slow gastric emptying
Use: approved for DM2 (but does cause weight loss)
SE: nausea

Question 4

Topiramate

Answer 4

GluR5 kainate R antagonist (mech unknown)
Use: seizures, migraines, *off-label for weight loss
SE: #1 & 2) mental/mm slowing & paraesthesias

Question 5

Naltrexone

Answer 5

opioid antagonist
=> anti-craving (mech. unknown)
Use: alcoholism, *off-label - weight loss
SE: nausea, liver f(x) test abnormalities, mood effects

Question 6

Loracaserin

Answer 6

selective 5-HT 2C R agonist
Use: weight loss (approved!)
SE: headache, dizziness, nausea

Question 7

Qsymia

Answer 7

= combo of Topiramate & Phentermine
=> targets reward pathway (CNS)
Use: weight loss (approved!)
SE: (less than topiramate alone) constipation, dry mouth

Question 8

Contrave

Answer 8

Combo of Naloxone & Bupropion
=> decrease cravings (opioid antag.) + increase satiety (5-HT reuptake inhibitor)
Use: weight loss (approved!)
SE: nausea, liver f(x) abnormalities, mood effects, increased BP