Obesity Drugs

Question 1

Orlistat
- MOA

Answer 1

Inhibit pancreatic lipase
- No breakdown of fat into absorbable Free Fatty Acids

NO appetite mechanism

Question 2

Orlistat
- Contraindications

Answer 2

• Synthroid
• Cyclosporine
• Anticonvulsants
• Anticoagulants

Multivitamin recommended
- Separate dose though

Question 3

Naltrexone/Bupropion
- MOA

Answer 3

Naltrexone
- Opioid receptor antagonist, prolongs appetite suppression

Bupropion
- Inhibits reuptake of dopamine and norepinephrine, induce satiety

Synergistic effect when used together

Question 4

Naltrexone/Bupropion
- Contraindication

Answer 4

• Uncontrolled hypertension
• MAOI use
• Opioid use
• Seizures
• Anorexia
• Discontinuation of depressive drugs and alcohol
• SSRIs, BB, TCA

Question 5

Naltrexone/Bupropion
- Taper

Answer 5

Take for 1 week then taper up by 1 tablet until 4 tabs daily

Question 6

GLP-1 Receptor Agonist
- MOA

Answer 6

Appetite surpression via neuronal pathway

Delayed gastric emptying

Question 7

GLP-1 Receptor Agonist
- Contraindication

Answer 7

• Family history of thyroid cancer
• Endocrine Neoplasia
• Type 1 DM

Question 8

Liraglutide
- Taper

Answer 8

Start: 0.6 mg
Taper: Increase by 0.6 mg until target of 3.0 mg

Question 9

Semaglutide
- Taper

Answer 9

Start: 0.25 mg
Taper: Every 4 weeks
0.5 –> 1 –> 1.7 –> 2.4

Can delay escalation if not tolerated well