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17 Cards in this Set
- Front
- Back
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Why use pharmacological treatment?
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-Induce Weight Loss
-Maintain Weight Loss -Cost Effectiveness (esp cause might need to not needing drugs for obesity comorbid condition) (BUT don't use drugs as easy way out, or laziness) |
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History of Pharmacologic treatment
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often disappointing results serious SEs, underresearched
1890s: thyroid hormone 1930: dinitrophenol 30'-60's: amphetamines (for increased metabolism, addictive tho) |
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Downsides of Pharmocological treatment
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Often Ineffective (or modest outcome)
Discontinuation = weight regain Major Side Effects |
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Phen/Fen Phenomenon
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(phentermine and fenfluramine)
Popular drug (despite subpar test results) led to valvular heart disease later (= $4 billion in cost of medical monitoring) |
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Types of weight loss drugs
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-Reduce energy intake (satiety)
-Reduce nutrient absorption/metabolism (lipases, oxidations up) -Increase energy expenditure |
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Appetite suppressant drug info, pros/cons
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alter CNS, dec reuptake Do, NE, HT
-Temporary effect, requires taking before meal -only slightly effective -addictive -SE = nervousness, insomnia, tachycardia, weigh regain |
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Drugs Reduce Nutrient absorption drugs: block CHO, lipid aborb
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carb, mostly lipid (about 1/3 eaten) blocked (block lipase)
Alter GI aborbtive sites or enzymes -many side effects: cramping, nausea, diarrhea, steatorrea, leakage, rectal bleeding) |
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Drugs reduce nutrient absorption: inhibit lipid synthesis/storage
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decrease FA produce/storage, increase fat oxidation
less side effects, but unknown long-term -High blood pressure |
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Drugs increase energy expenditure (NONE FDA APPROVED)
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Enhance thermogenesis/ inc BMR
- tinnitus, prolonged bleeding, GI dmg, inc protein catabolism, > heart size |
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Anti-obesity drugs on market
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All Schedule IV or V
(neurotransmitter drugs = IV, only take 12 weeks at time, heart disease/HT esp with sibutramine) ( |
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Safety Factors of NT drugs
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-Abuse
-valvular heart disease -primary pulmonary hypertension |
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Side effects for centrally acting drugs/NT drugs
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nervous,insomnia, depression,dizzy
headache,nausea,constipation Increase BP and heart rate (but no gastrointestinal issues really at least) |
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Contraindications (for NT drugs, especially sibutramine)
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hypertension
on antidepressant, migraine, analgesic meds Coronary artery disease, congestive heart disease, arrhythmias pregnant or a child |
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Rimonabat (appetite suppress.)
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Antagonist at cannabinoid 1 receptor, blocks oxigenic effects of endocannabinoids)
-severe psychiatric effect: anxiety, depression (double risk of suicide, thoughts of) |
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Guidelines prescribing pharmacological treatment:
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-Approved for maintaining weight loss esp
-(non responder what??) -good for failure to lose/maintain weight -based on clinician judgment |
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NHLBI criteria for drug use:
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BMI > 30, or >27 with comorbidity/concomitant risk factors
-Hypertension (HT) -dyslipidemia -Type II diabetes -sleep apnea -osteoarthritis |
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Proper drug usage
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For lifestyle change and
Multidisciplinary approach used: (nutrition, exercise, medical, behavior(motivation,habits etc)) |
