Weight Loss Pharmacology Flashcards
Orlistat
Pancreatic lipase inhibitor that blocks absorption of 1/3 of ingested fat. Lowers LDL and HbA1C. Can result in diarrhoea (due to increased fat in excrement). Pt will also need to be on vitamin supplements (A, D, E, K), as fat soluble vitamins will be lost.
Liraglutide
An analogue of glucagon-like peptide-1. It increases glucose dependent insulin secretion and suppresses inappropriate glucagon secretion. Delays gastric emptying, which slows glucose absorption and decreases appetite. Use as an adjunct to lifestyle modification.
Phentermine
Sympathomimetic with CNS stimulatory effects. Increases energy expenditure, suppresses appetite. Increases sympathetic stimulation (therefore increasing metabolism) by stimulating NA release and blocking NA re-uptake. Additionally affects dopamine. Contraindicated in hyperthyroidism, epilepsy and cardio/cerebrovascular disease.
What is leptin?
A hormone-like molecule that is released from adipose tissue. It helps regulate energy balance by inhibiting hunger. It acts on receptors in the hypothalamus, and leads to satiety, decreased food intake and increased energy expenditure in the periphery.
What is the definition of obesity?
Excess body fat adversely affecting health (and life expectancy).
What is BMI?
Current benchmark for measuring obesity. Body Mass Index = Weight (in KG)/Height2 (in m).
Obesity Treatment Pyramid
Lifestyle modification > medication > surgery
Why use medication to assist weight loss?
Medications are used to establish control and sustain control.
How is obesity treated/managed?
Diet and lifestyle changes are first line. Drugs can be an important tool to assist in weight loss. Must be aware of indications and contraindications.
How do incretin mimetics work?
- stimulate pancreas to release insulin
- reduce the amount of glucose released into the bloodstream by the liver
- slow down gastric emptying
- help patients to feel full and reduces their appetite
