Obesity Medications

Question 1

What are the brand names of Orlistat?

Answer 1

Xenical, Alli

Question 2

What are the indications for Orlistat?

Answer 2

preferred first choice; available for long-term treatment

Question 3

What is the MOA of Orlistat?

Answer 3

alters fat digestion by inhibiting pancreatic lipases, fat hydrolysis, & increasing fecal fat excretion

Question 4

What are the AEs of Orlistat?

Answer 4

GI (borborygmi, cramps, gas), decreases absorption of DEKA, renal calculi

Question 5

What are the contraindications of Orlistat?

Answer 5

patients w/malabsorptive disease, hx of Ca++ oxalate stones, cholestasis, pregnancy

Question 6

What are the brand names of Liraglutide?

Answer 6

Victoza, Saxenda

Question 7

What is the indication for Liraglutide?

Answer 7

alternative option for initial tx; good choice in DM2 & CV disease

used for initial BMI >/= 30kg/m2 or 27kg/m2 w/one comorbidity

Question 8

What is the MOA of Liraglutide?

Answer 8

GLP-1 receptor agonist; GI peptides that stimulate glucose dependent insulin secretion; delays gastric emptying

Question 9

What are the AEs of Liraglutide?

Answer 9

N/V (common)

diarrhea, hypoglycemia, anorexia

Question 10

When is Liraglutide contraindicated?

Answer 10

pregnancy

family hx of medullary thyroid CA or MEN 2a or 2b

Question 11

What is the warning with Liraglutide?

Answer 11

concomitant use with insulin

Question 12

What are the brand names of Lorcaserin?

Answer 12

Belviq, Belviq XR

Question 13

What is the MOA of Lorcaserin?

Answer 13

selective serotonin agonist; reduces appetite

Question 14

What are the AEs of Lorcaserin?

Answer 14

HA, URI, nasopharyngitis, dizzy, N

hypoglycemia in pts on oral DM meds or insulin

Question 15

What are the CIs of Lorcaserin?

Answer 15

Cr <30
pregnancy
use with other seratonergic meds (risk seratonin syndrome)

Question 16

What are the indications of Loracaserin?

Answer 16

similar efficacy as orlistat

trial showed safe as an addition to orlistat & liraglutide for initial pharm tx of obesity

Question 17

What is the brand name of Phentermine?

Answer 17

Adipex-P

Question 18

What are the indications for Phentermine?

Answer 18

short-term use only (up to 12w) d/t abuse potential & SEs

Question 19

What is the MOA of Phentermine?

Answer 19

sympathomimetic drug causing early satiety; stimulates release of norepi or inhibits reuptake & blocks serotonin reuptake

Question 20

What are the SEs of Phentermine?

Answer 20

Increased HR, BP, insomnia, dry mouth, constipation, nervousness

Question 21

What are the CIs of Phentermine?

Answer 21

HTN, CAD, Hyperthyroidism, hx drug abuse

Question 22

What is the brand name of Phentermine-topiramate?

Answer 22

Qsymia

Question 23

What are the indications for Phentermine-topiramate?

Answer 23

pts w/at least one weight-related comorbidity: HTN, DM, dyslipidemia; considered in those w/o CV dz who do not tolerate other single medications

Question 24

What are the AEs of Phentermine-topiramate?

Answer 24

dry mouth, constipation, paresthesias
With increased doses: depression, anxiety, decreased attention
Topiramate: renal calculi

Question 25

What are the CIs of Phentermine-topiramate?

Answer 25

pregnancy hyperthyroidism glaucoma pts on MAOIs

Question 26

What is the brand name of Bupropion-Naltrexone?

Answer 26

Contrave

Question 27

What are the indications for Bupropion-Naltrexone?

Answer 27

similar efficacy to lorcaserin but more SEs; ideal for obese smoker; used on presence of 1 obese related comorbidity

Question 28

What are the AEs of Bupropion-Naltrexone?

Answer 28

N, HA, constipation ?cardio effects? Warning in use of YA (bupropion)

Question 29

What are the CIs of Bupropion-Naltrexone?

Answer 29

pregnancy, HTN, eating disorders, chronic opioid use, seizure disorder, use w/other bupropion-containing meds, use w/MAOIs