Obesity Pharmacotherapy Exam 3 Flashcards
What are the medications associated with weight gain?
- Anticonvulsants (e.g. carbamazepine, gabapentin, pregabalin, valproic acid)
- Antidepressants (e.g. mirtazapine, tricyclics)
- Atypical antipsychotics (e.g. clozapine, olanzapine, quetiapine, risperidone)
- Conventional antipsychotics (e.g. haloperidol)
- Hormones (e.g. corticosteroids, insulin, medroxyprogesterone)
What should be done with the patient before initiation pharmacotherapy of obesity?
- Assess readiness to engage in weight loss efforts and identify potential barriers
- Educate on potential health consequences of excessive body weight
- Discuss risks of therapies
What are the different type of treatment options?
– Comprehensive lifestyle intervention
– Pharmacotherapy
– Implantable medical devices
– Bariatric surgery
When should pharmacotherapy of obesity be initiated?
- have failed to achieve/sustain weight loss with lifestyle alone
- BMI >= 30 kg/m2
- BMI >= 27 kg/m2 with > 1 comorbidity
Phentermine brand name
Adipex-P
When should phentermine be discontinued?
if tolerance develops
What can happen if you d/c phentermine abruptly?
- can cause caused extreme fatigue and depression
- will want to taper it off
CI to phentermine
– Cardiovascular disease
– Hyperthyroidism
– Substance abuse
– Glaucoma
Precautions in phentermine
– Renal impairment
– CNS depressants
phentermine drug interactions
- do not use with SSRI’s
- interaction with MAOI
patient education for phentermine
administer before breakfast or 1-2 hours after breakfast
orlistat brand name
- Xenical (Rx)
- Alli (OTC)
orlistat monitoring
s/s of liver toxicity and obtain LFTs if symptoms occur
orlistat patient education
– Take during or up to 1 hour after meal.
– Skip dose if meal skipped or contains no fat
– Supplement with MVI 2 or more hours before or after orlistat to prevent vitamin deficiency
lorcaserin brand name
Belviq (XR)
orlistat drug interaction
- warfarin
- decrease absorption of oral drugs
lorcaserin precautions
– Moderate renal impairment and severe hepatic impairment
– Increased risk of serotonin syndrome if used with other serotonergic or dopaminergic medications
– Valvular heart disease
lorcaserin monitoring
– CBC
– depression or suicidal thoughts
– s/s serotonin syndrome
– s/s vavlular disorder (based on history with fenfluramine)