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obesity
NEED TO KNOWS FOR TEST
| Question | Answer |
|---|---|
| homeopathic remedies and regulation | they are not regulated under DSHEA OTC: like dietary supplements, proof of safety/efficacy not required, expiration not required, Label needs (ingredient list, instruction for safe use, one use of self limiting conditions and amoutn of dilution) |
| Herbal/botanical medicine | regulated under DSHEA German commission E evaluates teh safety adn efficacy of herbs |
| why was ephedra removed from the marketchemical structure and brand name | due to risk of hemorrhagic stroke Brand name phenylpropanolamine DEXATRIM |
| what are the available appetite suppressants | sibutramine, orlistat for long term Short term phendimetrazine, phentaermine, diethylpropion, Herbals St Johns wort, 5-HTP, Hoodia |
| what does she want us to know about St. johns wort | no reliable evidence for weight loss, lots of drug-drug interactions, It is a CYP 3A4 INDUCER, works mainly on serotonin (little on NE and Dopamine) |
| which herbals are dietary supplements that are similar to caffeine | green tea, guarana, and mate |
| which dietary supplement may increase BP and HR | citrus aurantium (AKA bitter orange)brand name ADVANTRA Z contains 20 mg of synephrine |
| which herbal is a CYP 3A4 inhibitor | Citrus aurantium (AKA bitter orange) |
| which herbal black the absorption of fat/positively charge chitosan binds with negatively charge dietary fat | chitosan |
| which herbal has a risk of shell fish allergy | chitosan |
| which herbal has minimal benefits in obesity for patients with high blood pressure | chitosan |
| what about HOODIA? what are some other names | hoddia cactus, Kalahari Cactus, may work as an appetitie suppressant but enhancing sensation of satiety but don't know side effects or efficacy |
| which drug could be thought of as the new ephedra, what were the active ingredients and MOA, efficacy, and side effects | bitter orange or citrus aurantium, contains octopamine & synephrine, it's a thermogenic agent w/ adrenergic agonist activity, synephrine has alpha adrenergic effects, efficacy hasn't been study alone but in combo w/ caffeine & St. john's showed decrease |
| what is another name for MATE what is important to know about this one | yerba mate work like caffeine may be carcinogenic |
| what are the adverse effects of bitter orange | risk of MI, stroke & seizures increase, get increased HR, CI in patients with CVD |
| what are some more names for Green Tea | chinese tea, japanese tea |
| what is the mechanism for green tea and what is the active ingredients and side effects | contains caffeine and polyphenols, its a termogenic agent, polyphenols and caffeine act synergistrically to promote fat metbolism and cause thermogenesis, it is a CNS stimulant, SE: GI (NVD, bloating, flatulence) |
| what does the evidence say about Green tea for weight loss | more effective than just caffeine or placebo in promoting termogenesis but actual effect was not significant |
| what was the conculsion about guar gum | not effective and produced GI SE |
| what does the evidence say about hydroxy-methylbutyrate | it is ametbolite of leucine and results show fat mass reduction, no adverse events were reported and is available as a dietary supplement used by bodybuilders |
| what about psyllium or plantago psyllium | it is a water soluble fibre derived from ripe seeds but no significant changes in body weight were reported but the drug is well tolerate |
| what about garcinia cambogia | overall evidence is encouraging but side effects are HA URI and GI |
| what is E. sinica and what is the primary active constituent what does the evidence say | it is a evergreen shrub native to central asia, ephendrine is the primary active constituent and has been studied w/ caffeine & evidence states a 0.9 kg wt loss/ month > placebo. ADR: psychiatric autonomic or gastrointestial symptoms & heart palpitations |
| what about pyruvate for weight loss | promissing weight loss with no adverse events reported marked as metabolism enhancer if used in place of dietary glucose, at large doses significant GI SE |
| Glucomanna (konjac, Konjac Mannan) | related to guar gum ( contains a insoluable fiber so increases water absorption by the stool) and trials suggest significantly larger weight loss than placebo with no ADE reported but she said in OTC obstruction has been reported with tables |
| yohimbine | an alpha 2 receptor antagonist that is from ground bark of pausinystialia yohimbe (yohimb) a tall evergreen tree from central africa, confliction resuls with few adverse events impaired sleep, nervousness, HA and arthralgia |
| what about guggul | produces a gummy resin may lower lipids but contradictory evidence for weight loss |
| is calcium effective in weight loss | only if from dietary sources |
| what about conjugated linoleic acid (CLA) | it may shrink adipose tissue and reduce hunger and improve satiety but doesn't seem to reduce total weight or BMI and don't know long term use |
| which drugs for weight loss are possibly effective | calcium, psyllium and CLA but don't recommend using |
| which drugs have insufficient evidence to conclude | chormium, SJW, chitosan, Guggul, Pyruvate, and HOODIA |
| which drugs were shown to be ineffective | guar gum and garcinia |
| which drugs are considered unsafe | bitter orange, 5HTP adn Ephedra |
| diethylpropion what to know | brand name is tenuate, related to bupropion, may cause insomnia, diabetics may have to decrease dose, don't use if heart problems, on for short term, increase risk of seizures |
| Other anorexic drugs include | methamphetamine, dextroamphetamine, phentermine, benzphetamine, phendimetrazine, phenmetrazine, diethylpropion, mazindol, phenylpropanolamine, and sibutramine (a mixed adrenergic/serotonergic drug). |
| noradrenergic agents that are appetite suppressants | amphetamines, sympathomimetic agents (diethylpropion, benzphetamine, phentermine) |
| what are the SE of phentermine | insomnia, increased blood pressure, palpitations, and arrhythmias, cause hypertensive crisis (serotonin syndrome) with other MAOIs, may interact with TCA,helps with glycemic control so may need to reduce insulin, |
| when is phentermine CI | those who use cocaine, phencyclidine, methamphetamine, glaucoma, hypertension, unstable cardiovascular function Fenfluramine (in combo with phentermine is known as Phen-fen) |
| phentermine brand is and what is it indicated for | Fastin, Oby-trim, Adipex-P, Ionamin For short term use. Single daily dose of 30 mg in the morning or divided doses of 8 mg immediately before meals may be used. Evening or nighttime dose should be avoided due to insomnia risk |
| Other centrally active appetite suppressants that augment catecholamines that were developed for the treatment of obesity and may have a lower incidence and severity of CNS side effects compared with the amphetamines | (e.g., phentermine, mazindol, phendimetrazine, and diethylpropion) |
| amphetamine/dextroamphetamine | adderall and biphetamine |
| benzphetmaine hydrochloride | didrex |
| dextroamphetamine | dexedrine |
| diethylpropion hydrochloride | tenuate |
| mazindol | sanorex 1-mg tablet once a day, taken with food |
| methamphetamine hydrochloride | desoxyn |
| orlistat | xenical, alli |
| phendimetrazine tartrate | bontril,plegine, prelu-2, x-trozine,Adipost, Bontril PDM, Bontril Slow-Release, Melfiat, Obezine, Phendiet, Phendiet-105, PT 105, Plegine, Prelu-2, X-Trozine, |
| phenmetrazine | preludin |
| phentermine | adipex-p fastin obycap, phentrideAdipex-P, Fastin, Ionamin, Obenix, Oby-trim, Phentercot, Phentride, Pro-Fast, Teramine, Zantryl |
| phentermine resin | ionamin |
| sibutramine | meridia often is prescribed for at least the first four weeks. |
| Off-label weight loss drugs include: | *antidepressants such as bupropion*the anticonvulsant drugs topiramate and zonisamide (zonegran)*the diabetes medication metformin |
| Drugs withdrawn from the market Although effective for long-term weight loss, | fenfluramine (Pondimin and others), dexfenfluramine (Redux), and a fenfluramine/phentermine combination (fen/phen) |
| In February of 2004 the FDA prohibited the sale of dietary supplements containing ephedrine alkaloids, including | ephedra, Ma huang, Sida cordifolia, and pinellia, because of potential complications. Although they may effect modest short-term weight loss, these drugs raise blood pressure, stress the circulatory system, & have been linked to heart attack and stroke. |
| After beginning a weight loss drug, patients should return for follow-ups in | two to four weeks, monthly for three months, and then every three months for the first year, to monitor weight, blood pressure, pulse, and side effects, and have laboratory testing. |
| Amphetamine-type weight loss drugs should not be use by anyone with the following problems: | *high blood pressure*heart disease*an overactive thyroid gland*glaucoma |
| subitramine is known to interact with numerous other drugs, including the following | *pain relievers and muscle relaxants, sulfa antibiotics, antifungal medications, *sedatives, sleeping pills, tranquilizers*high-blood-pressure medications *migraine-headache medicationss, seizures meds as warfarin (Coumadin)*chemotherapies |
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lainylaina