Pharm, Drugs for Obesity Martin Flashcards
(21 cards)
phentermine and topiramate ER
most efficacious
>5% weight loss after 56 weeks at highest dose
avg patient went from 260 - 232 lbs
side effects phentermine topiramate (qsymia)
discontinuation ~40%
CI in pregnancy
only available through restricted access program designed to prevent fetal exposure
orlistat
OTC or Rx
pancreatic and gastric lipase inhibitor that dec absorption of fat
adverse effects orlistat
flatulence with discharge oily spotting fecal urgency after high fat indescretions discontinuation CI during pregnancy
Lorcaserin
selective serotonin 2C agonist suppresses appetite
shcedule IV controlled substance
patients who should stop taking lorcaserin
fail to lose >5% baseline weight by 12 weeks
adverse effects lorcaserin
HA nausea dizziness
CI pregnancy
do not take with MAOI SSRI SNRI
bupropion/naltrexone
appetite suppressant/opoid R antagonist
adverse effects bupropion/naltrexone
nausea (main reason discontinue)
vomiting, HA, constipation, dizziness and dry mouth
neuropsychiatric reactions
liraglutide
injectable GLP-1 agonist used in DM II
adverse effects liraglutide
nausea, vomiting, constipation and diarrhea
slows gastric emptying and may dec rate and extent absorption of other drugs
box warning on liraglutide
thyroid C cell tumors
CI in pregnancy
weight loss in DM on glucose lowering drugs
increase insulin sensitivity and may increase risk of hypoglycemia
which off label drug helps with modest weight loss
metformin
adjustable gastric banding
restrictive procedure not assoc with malabsorption
loss of excess weight over 10 years
sleeve gastrectomy
laparoscopic partial gastrectomy
loss of excess weight over 5 years
roux- en Y gastric bypass
mixed restrictive and malabsorptive procedure that involves creation of proximal pouch of stomach and anastomoses to limb of jejunum, bypassing most stomach and duodenum
excess weight loss after 2 years
safer gastric surgery
banding
Tx for severe binge eating disorder
Vyvanse- used for ADHD
most common adult eating disorder in US
severe binge eating disorder
adverse effects Vyvanse (lisdexamefatamine)
dry mouth, insomnia, dec appetite, constipation, feeling jittery and anxiety