pharm wk 2 Flashcards
(47 cards)
what are 2 examples of incretic mimetics
semaglutide and liraglutide
work on GLP1 or GIP
what is the example of appetite suppressant
buproprion
what is the lipase inhibitor example
orlistat
what is the goal of therapy for obesity
reduce excess body fat for health and not for cosmetic reasons; reducing weight by 5–10% can result in important health benefits
prevent weight regain
prevent and treat comorbidities
2 treatment phases of obesity
Induction of weight loss – achieved through caloric restriction
Prevention of weight regain – countering the neurobehavioural changes that seek to restore body weight to its original level
drugs associated with weight gain (5)
antidepressants - TCAs (amitriptyline)
antipsychotics (1st and 2nd generations)
corticosteroids (i.e. prednisone)
antihyperglycemic drugs (sulfonylureas. meglitinides, thiazolidinediones, insulin)
lithium (for mania)
what are the 2 appetite suppressants
bupropion and naltrexone (can combine)
what type of drug is bupropion
sympathomimetic (acts like NE/E and is stimulating)
what type of release does bupropion have
sustained release formula
other than appetite suppression, what else can bupropion be used for
antidepressant and smoking cessation aid
who is bupropion/naltrexone recommended for
Indicated for weight management alongside diet and exercise for those with a BMI of 30 or higher (27 if weight-related comorbidity present)
what hormones does bupropion/naltrexone mediate
Mediates hormones involved in appetite and reward
Adverse effects of bupropion
Dry mouth, constipation, agitation, insomnia, anxiety
Can cause seizures in rare instances with higher doses
Caution in patients with hepatic impairment
adverse effects of combining bupropion and naltrexone
Nausea, vomiting, constipation, headache, dizziness, insomnia, dry mouth
Contraindicated with concurrent opioid therapy (due to precipitation of opioid withdrawal)
Patients must be opioid free for 7 days prior to initiation of treatment
cautions for bupropion and naltrexone use
Avoid concurrent use of drugs that lower the seizure threshold.
Minimize or avoid alcohol consumption.
Avoid in patients with uncontrolled hypertension, seizure disorder, severe hepatic impairment, or end-stage renal failure.
what food should you take bupropion and naltrexone away from
high fat meal
orlistat îs a
lipase inhibitor
what does orlistat do ? by what %?
dont absorb fat
Pancreatic and gastric lipase inhibitor that reduces dietary fat absorption by 30%
adverse effects or orlistat
Oily spotting, flatus with discharge, fecal urgency.
Decreased absorption of fat-soluble vitamins
Contraindicated in patients with chronic malabsorption syndrome or cholestasis.
cautions with orlistat
Advise patients to take a multivitamin daily ≥2 h before or after orlistat or at bedtime
A high fat intake is poorly tolerated
who is orlistat less effective in
Less effective in patients on low-fat diets and is difficult to take for individuals with irregular eating patterns
2 major incretin hormones in humans are
glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)
what do incretin hormones do
responsible for most of the glucose-induced insulin secretory response following glucose ingestion
what are GLP-1 and GIP (incretins) metabolized by
by the enzyme dipeptidyl peptidase 4 (DPP4)
