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WorksheetsKhan - Obesity
Total questions: 40
Worksheet time: 40mins
Therapeutic agents: Centrally acting
GLP-1 agonists
Phentermine
Phentermine topiramate ER
Naltrexone Bupropion
Setmelanotide
Therapeutic agents: Centrally acting --> short term
GLP-1 agonists
Phentermine
Phentermine topiramate ER
Naltrexone Bupropion
Setmelanotide
Therapeutic agents: Peripherally acting
GLP-1 agonists
Orlistat
Famotidine
Naltrexone Bupropion
Overweight BMI
25-29.9 kg/m2
> 30 kg/m2
Obese BMI
25-29.9 kg/m2
> 30 kg/m2
GOAL for overweight and obesity
Increase calories
Decrease Calories
Increase energy expenditure
BOTH
Eat subway at least one weekly
Risk factors to consider for overweight and obesity
CAD, HTN, dyslipidemia
Type ll diabetes and stroke
sleep apnea and depressions
infertility
Allergies
For treat obesity
Drug therapy
dietary plan
physical activity
just dietary plan
just drug therapy
For treat obesity and overweight: Stimulant drugs --> jump start agent for ____
short term
long term
For treat obesity and overweight: Stimulant drugs --> anti-obesity drugs agent for ____
short term
long term
Agents that can promote weight gain
antipsychotics: clozapine, olanzapine, risperidone, quetiapine
Insulin
Sulfonylureas
TZD
Lithium
Agents that can promote weight gain
Valproic acid
gabapentin
pregabalin
mirtazapine, amitriptyline, nortriptyline
Orlistat
Inhibits GI lipase --> decrease dietary fat (triglyceride) absorption (plus a low-fat diet)
Valproic acid
gabapentin
pregabalin
Orlistat
ADRs: GI (fatty stool, intestinal gas with discharge, increase number of bowel movement)
Valproic acid
gabapentin
pregabalin
Orlistat
C/l: pregnancy, malabsorption
Valproic acid
gabapentin
pregabalin
Orlistat
Decrease absorption of fat-soluble vitamins (ADEK), decrease cyclosporine and decrease levothyroxine absorption --> take separately
Valproic acid
gabapentin
pregabalin
Orlistat
____ functions:
-Increases insulin synthesis and release
-Lowers glucagon release --> reduced hepatic glucose production
-Slows gastric emptying
-Stimulates GLP-1 receptor in the hypothalamus --> decrease food intake
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
SC injection
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Liraglutide, semaglutide
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Binds to and activate receptors --> G-protein coupled receptor
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Boxed warnings: Risks of thyroid C cell carcinoma, contraindicated in MEN (multiple endocrine neoplasia)
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
ADRs: Hypoglycemia, pancreatitis, nausea
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
ADRs: Tachycardia, elevated HR, elevated BP, insomnia
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Short-term use (up to 12 weeks)
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Contraindications: uncontrolled hypertension, hyperthyroidism, pregnancy
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Sympathomimetic agent
-Increase norepinephrine release
-Decrease NE reuptake from the synapse
-Increases NE in the hypothalamus --> decrease appetite
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
ADRs: tachycardia, vision problems, insomnia
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
C/l: pregnancy, glaucoma, hyperthyroidism
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Drug interactions: MAOI and phentermine --> hypertensive crisis
GLP-1 agonists
Phentermine topiramate extended release
Phentermine
Orlistat
Setmelanotide
Peptide analog of endogenous alpha-MSH
Melanocyte stimulating hormones MSHs act by their specific interactions with five melanocortin receptor (MCR) subtypes (MC1R-MC5R)
MCRs (MC1R-MC5R) are G-protein coupled receptors
Setmelanotide activates MC4 receptor in the brain --> decrease hunger and promote weight loss
ADRs: injection site reaction, hyperpigmentation, HA, GI ADRs
Phentermine topiramate extended release:
-Migraine, epilepsy
-Weight loss --> undesirable effect
Phentermine
Topiramate
Phentermine topiramate extended release:
Teratogenic, increases the risk of congenital fetal oral-cleft formation (negative pregnancy test needed before treatment and monthly thereafter)
Phentermine
Topiramate
Phentermine topiramate extended release:
Taper off due to seizure risk from _____ (rebound phenomenon)
Phentermine
Topiramate
Naltrexone bupropion extended release: Naltrexone
Opioid antagonist
Alcohol and opioid dependence
Reuptake inhibitor of NE and dopamine
Depression and smoking cessation
Naltrexone bupropion extended release: Bupropion
Opioid antagonist
Alcohol and opioid dependence
Reuptake inhibitor of NE and dopamine
Depression and smoking cessation
Naltrexone bupropion extended release: _____ stimulates release of alpha-melanocyte stimulating hormone (alpha-MSH) from pro-opiomelanocortin (POMC) in the hypothalamus
Bupropion
Naltrexone
Naltrexone bupropion extended release: alpha-MSH
decreases food intake
increases food intake
Boxed warnings: suicidal thinking and behavior (bupropion)
Naltrexone bupropion extended release
phentermine
phentermine topiramate extended release
Setmelanotide
Naltrexone bupropion extended release contraindications
Pregnancy
Uncontrolled hypertension
Chronic opioid use
Seizure disorder
During and within 14 days of taking MAOIs
Naltrexone bupropion extended release --> bupropion
Pregnancy
Uncontrolled hypertension
Chronic opioid use
Seizure disorder
During and within 14 days of taking MAOIs
