Obesity Drugs

sumnerl's version from 2015-04-29 14:27

Section 1

Question Answer
Phentermine-Adipex dosing15-37.5 mg/day, 8 mg TID w/ food
Orlistat Rx Xenical dosing120 mg TID w/food
Orlistat OTC Ali60 mg TID w/food
Phentermine/Topiramate SR - Qsymia dosing initial3.75 mg/23 mg daily X 14 days then 7.5 mg/46 mg daily
Phentermine/Topiramate SR - Qsymia dosing increased11.25 mg/69 mg daily X 14 days then 15 mg/92 mg daily
Lorcaserin - Belviq dosing10 mg BID
Buprpprion SR/Naltrexone SR - Contrave dosing90mg/8 mg tablet 1PO QD X1wk then 1PO BID X1wk then 2 PO AM + 1PO PM X1wk then 2PO BID
Liraglutide - Saxenda dosing0.6 mg SQ QDX1wk then 1.2 mg SQ QDX1 wk then 1.8 mg SQ QDX1wk then 2.4 mg SQ QDX1wk then 3.0 mg SQ QD

Section 2

Question Answer
Phentermine MOAenhanced NE and DA neurotransmission-unsure how it makes people lose weight
Orlistat MOAReversible lipase inhibitor- decreases fat available for storage
Topiramate MOAIncreased satiety due to decrease in GI motility, increased taste aversion, and increased overall energy expenditure
Lorcaserin MOASelective serotonin 2c receptor agonist
Buproprion MOADA agonist activates POMC neurons - causes satiety
Naltrexone MOAinhibits negative feedback of b-endorphin - inhibits negative feedback so you still get satiety
Liraglutide MOAGLP-1 analog but used at higher doses than for DM

Section 3

Question Answer
Phentermine SEinsomnia, increased BP and HR, palpitations, Arrhythmias
Orlistat SEheadache, oily spotting, abd pain, flatus w/ discharge, fecal urgency, fatty stool, oily evacuation, increased defecation, fecal incontinence - they will shit themselves!
Phentermine/Topiramate SEParethesia, dry mouth, constipation, headache, altered taste, insomnia, memory/concentration impairments, depression, dizziness
Lorcaserin SEHeadache, dizziness, nausea, fatigue, back pain, constipation, dry mouth, hypoglycemia
Buproprion/Naltrexone SENausea, Constipation, HA, Dizziness, insomnia, dry mouth, tremor, upper abd pain, tinnitus
Liraglutide SENausea, Hypoglycemia, Diarhea, constipation, vomiting, HA, dyspepsia, fatigue

Section 4

Question Answer
Phentermine CICVD, moderate-severe htn, glaucoma, concommitant MAOI use
Orlistat CI chronic malabsorption syndrom, cholestatis
Orlistat cautionfat soluble vitamin deficiency, associated with severe liver injury
Phentermine/Topiramate cautionlinked to increased risk of cleft lip and palate with exposure during first trimester, use caution in women of childbearing age, increased hr
Phentermine/Topiramate CIpregnancy, glaucoma, hyperthyroidism
Lorcaserin Cautionpatients may be at risk of developing serotonin syndrome when prescribed with other serotonergic agents
Lorcaserin CIpregnancy
Buproprion/Naltrexone CIseizure disorder, hx of bulimia or anorexia nervosa, uncontrolled HTN, abrupt d/c of alcohol, opioid use, MAOI within 14 days
Buproprion/Naltrexone warningantidepressant medication can increase risk of suicidal ideation
Liraglutide CIpersonal or family hx of medullary thyroid carcinoma

Section 5

Question Answer
This medication only approved for short term tx and other medications are approved for long term txPhentermine
This medication can increase BP and HRPhentermine
This medication should be combined with lifestyle modificationsALL OF THEM!!!
Patients should take a multivitamin containing fat soluble vitamin 2 hours before or after their doseOrlistat
Patients should avoid a high fat diet (>30% total daily calories) to decrease GI events. Take psyllium at bedtime to help decrease these SEOrlistat
If the meal does not contain fat, the patient does not need to take a doseOrlistat
Most of the GI effects lasted only 1-4 wksOrlistat
Patients who do not lose at least 3% of body weight by 12 wks should have their dose increased, if a 5% weight loss has not occurred after another 12 wks the medication should be discontinuedPhentermine/Topiramate
Women of childbearing age must have a negative pregnancy test before starting the medication and every month while using the medication in addition to using effective contraception consistentlyPhentermine/Topiramate
This medication may increase breakthrough bleeding in women using oral contraceptivesPhentermine/Topiramate
This medication should not be discontinued abruptly, taper over 1 week with 1 does every other dayPhentermine/Topiramate
This medication may cause worsening of depression/suicidal thoughts/ideationPhentermine/Topiramate
This medication may cause disturbances in attention, concentration, memory, and word finding, can cause insomniaPhentermine/Topiramate
This medication can only be dispensed through certified pharmacies and prescribed by certified prescribersPhentermine/Topiramate
Patients who do not lose at least 5% of body weight by 12 wks should discontinue txLorcaserin
This medication has been associated with disturbances in attention or memoryLorcaserin
This medication may be associated with worsening of depression/ suicidal thoughts/ideation, careful in combination with other serotonin drugsLorcaserin
This medication may have an increased risk of priapismLorcaserin
This medication has been associated with a feeling of euphoria, but can cause undesirable effects from itLorcaserin
Patients with T2DM have experienced an increase in hypoglycemia eventsLorcaserin
Blood Pressure and plus should be monitored with this medicationBuproprion/Naltrexone
You should not take this medication if you have a history of seizuresBuproprion/Naltrexone
You should not take opioids while on this medicationBuproprion/Naltrexone
Patients who do not lose at least 5% of body weight by 12 wks should discontinue treatmentBuproprion/Naltrexone
Tablets cannot be broken, chewed, or crushes d/t SR formulationBuproprion/Naltrexone
Avoid taking this medication with a high fat meal (increased abs so increased seizure risk)Buproprion/Naltrexone
If the patient has not lost at least 4% of body weight at 16 wks the medication should be discontinuesLiraglutide
The dose of insulin secretagogues (sulfonaureas) should be decreased by halfLiraglutide
To decrease the risk of nausea and dyspepsia, decrease meal size by halfLiraglutide
This medication should be stored int he fridge prior to use, after first use it can be stored at room temp for up to 30 daysLiraglutide

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