obesity and thyroid

Answer 1

Question: Can you tell me about Orlistat?
Answer:

Class: Reversible Lipase Inhibitor

Mechanism: Binds covalently to gastric and pancreatic lipases → inhibits breakdown of triglycerides → excreted unchanged

Use: Weight reduction for patients with BMI >30 or BMI >28 with comorbidities (e.g. DM2)

Side Effects: Oily stools, increased defecation urgency, oily rectal discharge, flatulence, abdominal discomfort

Note: Should be consumed just before meals

Contraindications: Interferes with fat-soluble medications (e.g. vitamins A, D, E, K)

Answer 2

Question: Can you tell me about Levothyroxine?
Answer:

Class: Thyroid Hormone

Mechanism: Mimics endogenous T4 action

Use: Hormone therapy for hypothyroidism (primary)

Side Effects: Angina, anxiety, arrhythmias, insomnia

Contraindications: CVD in older patients

Monitoring: TSH, T4 levels

Important: To be taken on an empty stomach (metal ions can affect absorption)

Pharmacokinetics: Long half-life (7 days) → takes time to reach steady state

Answer 3

Question: Can you tell me about Liothyronine?
Answer:

Class: Thyroid Hormone Analogue

Mechanism: Mimics endogenous T3 action

Use: Emergency treatment for hypothyroidism

Side Effects: Angina, anxiety, arrhythmias, insomnia

Monitoring: TSH, T4 levels

Answer 4

Question: Can you tell me about Carbimazole and Propylthiouracil (PTU)?
Answer:

Class: Thionamide (Propylthiouracil is a prodrug)

Mechanism: Anti-thyroid activity → inhibits thyroid hormone synthesis

Use: Hyperthyroidism

Side Effects:

Rare/very rare: Bone marrow disorders, haemolytic anaemia, SCARs (Severe Cutaneous Adverse Reactions)

PTU: Hepatotoxicity risk

Contraindications: Bone marrow suppression → discontinue if severe blood disorders occur

Monitoring: Liver function, WBC count