Pharm - Obesity Flashcards
What is the primary goal of obesity therapy?
to reduce excess body fat for health reasons, aiming for a weight loss of 5-10% to achieve significant health benefits
What are the 2 main phases of obesity treatment?
- induction of weight loss: achieved through caloric restriction
- Prevention of weight regain: counteracting neurobehavioral changes that promote weight restoration
Name a commonly used appetite suppressant for obesity.
Bupropion (alone or in combination with naltrexone)
What is the mechanism of action of Orlistat?
it is a pancreatic and gastric lipase inhibitor that reduces dietary fat absorption by approx. 30%
List some common adverse effects of Bupropion
Dry mouth, constipation, agitation, insomnia, anxiety, and potential seizures at higher doses
What are the adverse effects associated with Orlistat?
Oily spotting, flatus with discharge, fecal urgency, and decreased absorption of fat-soluble vitamins
What are incretin mimetics, and name two examples
incretin mimetics are GLP-1 agonists that help reduce appetite
ex. liraglutide and semaglutide
what is the expected weight loss from liraglutide over two years?
approx 8 kg when combined with lifestyle measures
what are some drugs associated with weight gain?
antidepressants, antipsychotics, corticosteroids, and certain antihyperglycemic drugs
What is the significance of the STEP trials?
they investigated the efficacy of semaglutide for weight loss, showing significant results compared to placebo
What is the recommended weight gain target during pregnancy for women with obesity?
no more than 5-9.1 kg (11-20 lbs)
What should be done if a patient does not achieve at least 5% weight loss after 12 weeks on GLP-1 agonists?
discontinue the medication
What is the role of GLP-1 in the body?
GLP-1 reduces food intake and appetite, increases satiety, and decreases gastric emptying
what is the average weight loss associated with semaglutide over two years?
approx 16 kg when used in conjunction with lifestyle changes
what are the common gastrointestinal side effects of GLP-1 agonists?
nausea, vomiting, constipation, and diarrhea
what should patients taking Orlistat be advised regarding vitamin intake?
they should take a multivitamin daily at least 2 hours before or after taking Orlistat
what are the contraindications for using Liraglutide?
Personal or family hisotry of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2 (MEN 2), and pregnancy
what is the average weight gain associated with tricyclic antidepressants like amitriptyline?
approx 1.8 kg during the first 3 months of therapy
How does Bupropion/naltrexone work for weight management?
it mediates hormones involved in appetite and reward, leading to a new weight loss of 4.2% over 48 weeks
what is the average weight gain associated with insulin therapy?
up to 8 kg during an intensive 3 month course of therapy
what are the key findings from the meta-analysis regarding GLP-1 analogues?
Evidence of appetite suppression, delayed gastric emptying, and changes in taste and food preferences.
What lifestyle modifications are recommended alongside pharmacotherapy for obesity?
Adherence to a reduced-calorie diet (500 kcal deficit) and increased physical activity (150 minutes per week).
What is the expected weight loss from Bupropion at 400 mg over 24 weeks?
A net weight loss of approximately 5.1%.
What are the potential risks associated with Semaglutide?
Increase in amylase and lipase levels, suggesting possible pancreatitis.