Pharm-obesity

Question 1

5 drugs that cause weight gain?

Answer 1

• antidepressants (1.8 kg in 3 mos)
• antipsychotics (9-12 kg)
  -corticosteroids (2 kg in 6 mos)
• antihyperglycemic drugs (> 5 kg in 3012 mos)
• lithium (> 10 kg in 6-10 yrs)

Question 2

What drugs are appetite suppressants?

Answer 2

Bupropion + naltrexon

Question 3

What drug is an lipase inhibitor?

Answer 3

Orlistat

Question 4

What drugs are incretin mimetic?

Answer 4

Liraglutide and semaglutide

Question 5

What drugs has a sympathomimetic mech of action?

Answer 5

Bupropion

Question 6

What drug mediated hormones involved in apetite and reward?

Answer 6

Bupropion + naltrexone

Question 7

What drug decreases dietary fat absoprtion by 30%?

Answer 7

orlistat

Question 8

What drugs are GLP-1 agonist?

Answer 8

Liraglutide + semaglutide

Question 9

What drug causes the most weight loss?

Answer 9

Semaglutide (16 kg over 2 years)

liraglutide: 8 kg over 2 years

Orlistat: 2.9% in 1 yr

Bupropion: 2.2% in 24 wks(300 mg); 5.1% (400 mg)

Bupropion + naltrexone: 4.2% in 48 weeks

Question 10

Which drug was rebranded for obesity (initially T2DM)

Answer 10

liraglutide

Question 11

Which drugs is also an antidepressant and smoking cessation aid?

Answer 11

Bupropion

Question 12

What drug?
Dry mouth, constipation, agitation, insomnia, anxiety

Seizures in ↑ doses (rare)

Caution: pts w/ hepatic impairment

Answer 12

Bupropion

Question 13

What drug?
Dry mouth, constipation, insomnia, headache, dizziness, nausea, vomiting

CI: concurrent opioid therapy (precipitation of opioid withdrawal → must be opioid free 7 days)

Caution: avoid concurrent drug use that ↓ seizure threshold
Avoid alcohol
Avoid taking w/ high fat meal
Avoid in pts w/ uncontrolled hypertension, seizure disorder, severe hepatic impairment, end-stage renal failure

Answer 13

Bupropion + naltrexon

Question 14

What drug?
Oily spotting, flatus w/ discharge, fecal urgency
↓ absorption of fat-soluble vitamins

CI: pts w/ chronic malabsorption syndrome, cholestasis

Cautions: pts to take multivitamin ≥ 2 hr before/ after orlistat
High fat intake poorly tolerated
Less effective in pts on low-fat diets + difficult w/ those w/ irregular eating patterns

Answer 14

Orlistat

Question 15

What drug?
Nausea, vomiting, constipation + diarrhea (most common)
- can be minimized by slow titration
Pancreatitis (rare)
Severe hypoglycemia in pts w/ T2DM (might need to adjust diabetes meds)

Caution: pts w/ ♥ rhythm disturbances, hepatic insufficiency, severe renal impairment
- Should not be used w/ IBS

CI: pregnancy, breastfeeding, f hx of medullary thyroid carcinoma or multiple endocrine neoplasia

Answer 15

Liraglutide

Question 16

What drug?
Nausea, diarrhea, abdominal pain, vomiting, constipation, digestive upset, fatigue, dizziness

↑ in amylase + lipase (→ pancreatitis)

Answer 16

Semaglutide