Weight loss medications: Nursing Pharmacology
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Notes
Notes
| WEIGHT LOSS MEDICATIONS | |||
| DRUG NAME | benzphetamine hydrochloride (Didrex), diethylpropion hydrochloride (Tenuate) | orlistat (Xenica, Alli) | phentermine (Ionamin) |
| CLASS | Anorexiants | Lipase inhibitors | Sympathomimetic medications |
| MECHANISM OF ACTION | ↑ release of norepinephrine and dopamine in the satiety center → ↓ appetite | Inhibit fat absorption in the GI tract | ↓ reuptake of norepinephrine and dopamine → ↑ concentration of norepinephrine and dopamine in the synaptic cleft → ↓ perception of hunger |
| ROUTE(S) OF ADMINISTRATION |
| ||
| SIDE EFFECTS |
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|
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| WEIGHT LOSS MEDICATIONS, PART 2/3 | ||
| DRUG NAME | liraglutide (Saxenda, Victoza) | naltrexone/bupropion (Contrave) |
| CLASS | GLP-1 receptor agonists | Opioid antagonists & Atypical antidepressants |
| MECHANISM OF ACTION |
| Bupropion: Stimulates POMC neurons in the hypothalamus to ↑ release of hormones → ↑ energy output & ↓ appetite Naltrexone: Binds to opioid receptors without activating them, → POMC neurons stay stimulated longer by bupropion |
| ROUTE(S) OF ADMINISTRATION | SubQ | PO |
| SIDE EFFECTS |
|
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| WEIGHT LOSS MEDICATIONS, PART 3/3 | |||
| DRUG NAME | (all drugs from parts 1&2) benzphetamine hydrochloride (Didrex), diethylpropion hydrochloride (Tenuate, orlistat (Xenica, Alli), phentermine (Ionamin), liraglutide (Saxenda, Victoza), naltrexone/bupropion (Contrave) | ||
| INDICATIONS |
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| CONTRA- INDICATIONS AND CAUTIONS |
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| NURSING CONSIDERATIONS | Assessment and Monitoring Assessment
Monitoring
Client Education
| ||
Transcript
Weight loss medications can be used for the short-term management of obesity, and include anorexiants, sympathomimetic medications, lipase inhibitors, glucagon-like peptide-1 or GLP-1 receptor agonists, as well as opioid antagonists combined with atypical antidepressants.
Starting with anorexiants, the most commonly used are benzphetamine and diethylpropion, which are taken orally. These medications are believed to decrease appetite by stimulating the release of dopamine and norepinephrine in the satiety center of the brain, which is located in the hypothalamic and limbic areas. As a result, these neurotransmitters ultimately increase the feeling of satiety and decrease the perception of hunger.
Then, there are sympathomimetic medications, among which the most commonly used one for weight loss is phentermine, which is taken orally. Once administered, phentermine is absorbed into the bloodstream, and travels to the brain.
Here, it works at the synaptic cleft by inhibiting the reuptake of the neurotransmitters dopamine and norepinephrine. This results in an increased concentration of these neurotransmitters within the synaptic cleft, ultimately decreasing the perception of hunger.
Moving on, lipase inhibitors include orlistat, which is taken orally. This medication acts in the gastrointestinal tract by inhibiting the absorption of fats, causing them to get excreted in the feces.
Summary
Weight loss medications can help manage obesity in the short term, and include anorexiants, sympathomimetic medications, lipase inhibitors, GLP-1 receptor agonists, and opioid antagonists with atypical antidepressants. However, clients can experience different side effects depending on the medication taken, such as agitation, anxiety, oily rectal leakage, headaches, dizziness, and abdominal pain. Weight loss medications are contraindicated in individuals with a history of stroke, seizures, and psychiatric conditions like anorexia nervosa, depression, and bipolar disorder.
When caring for a client prescribed weight loss medication, a nursing assessment should be done to establish a baseline for weight, BMI, and vital signs. Client education is a crucial aspect of care, with a focus on safe self-administration of the medication, recognizing and reporting side effects, and adhering to any lifestyle modifications recommended by the healthcare provider, such as changes in diet and exercise.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Addiction potential of phentermine prescribed during long-term treatment of obesity" International Journal of Obesity (2013)
- "Lehne's Pharmacology for Nursing Care" Elsevier Health Sciences (2014)
- "Orlistat" StatPearls Publishing LLC (2021)
- "Obesity" undefined (2021)
- "Orlistat" undefined (2016)
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