32.2 Anorexiants
2 min read•june 18, 2024
are that help manage weight by reducing hunger and increasing fullness. These medications work through various mechanisms, targeting the central nervous system to promote weight loss alongside lifestyle changes.
When combined with a healthy diet and exercise, anorexiants can lead to significant weight loss and improve obesity-related conditions. However, they come with potential side effects and interactions, requiring careful patient selection, monitoring, and education for safe and effective use.
Anorexiants in Weight Management
Key features and mechanisms of action
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- Anorexiants (appetite suppressants) reduce appetite and promote weight loss
- Decrease hunger and increase fullness by acting on the central nervous system
- Mechanisms vary by drug
- (, )
- Releases , reducing appetite
- Increases energy expenditure and fat breakdown (lipolysis)
- ()
- Activates 2C receptors in the hypothalamus
- Increases satiety and decreases food intake
- Naltrexone/Bupropion (Contrave)
- Opioid antagonist (naltrexone) and antidepressant (bupropion) combination
- Naltrexone blocks opioid receptors, reducing eating reward
- Bupropion increases and norepinephrine, suppressing appetite and increasing energy expenditure
- (, )
Therapeutic benefits, side effects, and interactions
- Benefits
- Promote weight loss with reduced-calorie diet and increased physical activity
- May improve obesity-related conditions (, dyslipidemia, type 2 diabetes)
- Side effects
- Phentermine: dry mouth, insomnia, constipation, irritability, increased heart rate and blood pressure
- Lorcaserin: headache, dizziness, fatigue, nausea, constipation
- Naltrexone/Bupropion: nausea, constipation, headache, vomiting, dizziness
- Interactions
- Phentermine
- : hypertensive crisis risk
- Serotonergic drugs: potential
- Lorcaserin
- Serotonergic drugs: increased serotonin syndrome risk
- CYP2D6 inhibitors: may increase lorcaserin levels
- Naltrexone/Bupropion
- MAOIs: contraindicated due to hypertensive reaction risk
- CYP2B6 inducers: may decrease bupropion levels
- Phentermine
Nursing considerations
- Assessment
- Obtain medical history (psychiatric, substance abuse)
- Measure baseline weight, , vitals, labs (lipids, glucose)
- Patient selection
- Ensure criteria met (BMI ≥30 or ≥27 with comorbidities)
- Consider contraindications (pregnancy, glaucoma, cardiovascular disease history)
- Monitoring
- Regularly assess weight, BMI, vitals, adverse effects
- Monitor for abuse or dependence signs, especially with phentermine
- Patient education
- Emphasize combining medication with lifestyle changes
- Instruct on administration, side effects, when to seek medical attention
Patient education plan
- Provide clear instructions on dosage, administration, treatment duration
- Emphasize reduced-calorie diet and regular physical activity importance
- Discuss realistic weight loss expectations (5-10% of initial weight)
- Advise reporting adverse effects or concerns to healthcare provider
- Encourage regular follow-ups to monitor progress and adjust treatment
- Stress not sharing medications, proper storage and disposal
- Educate on signs and symptoms of complications (serotonin syndrome, hypertensive crisis)
- Remind anorexiants are not long-term solutions, lifestyle changes crucial for maintaining weight loss
Key Terms to Review (33)
Adipex-P: Adipex-P is a brand name for phentermine, an anorexiant used to assist in weight loss by suppressing appetite. It is typically prescribed for short-term use in conjunction with diet and exercise.
Anorexiants: Anorexiants are a class of drugs that suppress appetite, primarily used to treat obesity. They act on the central nervous system to reduce hunger sensations.
Appetite Suppressants: Appetite suppressants, also known as anorexiants, are a class of drugs that reduce feelings of hunger and the desire to eat. These medications work by affecting the neurotransmitters and hormones in the brain that regulate appetite and satiety, leading to decreased food intake.
Belviq: Belviq, also known as lorcaserin, is a prescription medication approved for the treatment of obesity. It works as an anorexiant, which is a class of drugs that suppress appetite and promote weight loss.
Benzphetamine: Benzphetamine is a sympathomimetic amine used as an appetite suppressant in the short-term management of obesity. It acts on the central nervous system to increase heart rate and blood pressure, thereby reducing appetite.
BMI: BMI, or Body Mass Index, is a measure of body fat based on a person's weight and height. It is a widely used screening tool to assess overall health and the risk of developing certain medical conditions related to weight.
CYP450: CYP450 refers to a superfamily of enzymes, primarily located in the liver, that are responsible for the metabolism and breakdown of various drugs and other xenobiotics. These enzymes play a crucial role in the pharmacokinetics of many medications, influencing their absorption, distribution, metabolism, and elimination.
Dopamine: Dopamine is a neurotransmitter that plays a crucial role in the brain's reward and pleasure centers, as well as in the regulation of various physiological processes. It is involved in a wide range of functions, from motor control and cognition to emotional and behavioral responses, making it a key player in understanding and treating numerous nervous system disorders.
Eating disorder: Eating disorder is a mental health condition characterized by abnormal or disturbed eating habits that negatively impact physical and mental health. Common types include anorexia nervosa, bulimia nervosa, and binge-eating disorder.
FDA Approval: FDA approval is the process by which the United States Food and Drug Administration (FDA) authorizes the sale and use of a new drug, medical device, or other regulated product. This approval ensures the safety and efficacy of these products before they can be marketed and distributed to the public, particularly in the context of anorexiants.
Grades of hypertension: Grades of hypertension classify the severity of high blood pressure based on systolic and diastolic measurements. These grades help guide treatment decisions and risk assessment.
Hyperglycemia: Hyperglycemia refers to an abnormally high level of glucose in the bloodstream. It is a key feature in the pathophysiology of various medical conditions, particularly diabetes mellitus, and can have significant implications for fluid and electrolyte balance, inflammatory processes, and overall health.
Hypertension: Hypertension, also known as high blood pressure, is a chronic medical condition in which the blood pressure in the arteries is elevated, increasing the risk of heart disease, stroke, and other health complications. It is a key term that is closely connected to various topics in pharmacology, including the management of cardiovascular conditions and the use of specific drug classes to control blood pressure.
Lomaira: Lomaira is a low-dose, short-term anorexiant used for weight management. It contains phentermine, which suppresses appetite.
Lorcaserin: Lorcaserin is a selective serotonin 2C (5-HT2C) receptor agonist that is used as an anorexiant, a medication that suppresses appetite and promotes weight loss. It works by activating the 5-HT2C receptor in the hypothalamus, which is involved in the regulation of appetite and energy balance.
MAOIs: MAOIs, or Monoamine Oxidase Inhibitors, are a class of medications primarily used to treat depression. They work by inhibiting the activity of the enzyme monoamine oxidase, which is responsible for breaking down neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. By preventing this breakdown, MAOIs can lead to an increase in the availability of these neurotransmitters, helping to alleviate the symptoms of depression.
National Institutes of Health (NIH): The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It funds and conducts research to advance knowledge and improve human health.
Neurotransmitter Modulation: Neurotransmitter modulation refers to the process by which the release, reuptake, and signaling of neurotransmitters in the brain and nervous system are regulated and adjusted. This is a crucial mechanism that allows the nervous system to fine-tune its responses and adapt to various internal and external stimuli, particularly in the context of anorexiants.
Norepinephrine: Norepinephrine is a neurotransmitter and hormone produced by the adrenal glands and certain neurons in the brain. It plays a crucial role in the body's sympathetic nervous system, responsible for the 'fight-or-flight' response, and is involved in a variety of physiological and psychological processes.
Obesity Treatment: Obesity treatment refers to the various medical and lifestyle interventions aimed at managing and reducing excessive body weight. It is a critical aspect of healthcare, particularly in the context of 32.2 Anorexiants, as obesity can have significant implications on an individual's overall health and well-being.
Off-Label Use: Off-label use refers to the practice of prescribing a medication for a purpose or in a manner that is not approved by the regulatory authorities, such as the Food and Drug Administration (FDA) in the United States. This term is particularly relevant in the context of CNS Stimulants and Nonstimulants, as well as Anorexiants, where healthcare providers may utilize medications for indications or patient populations that are not included in the official product labeling.
Phendimetrazine: Phendimetrazine is a sympathomimetic amine used as an anorexiant to aid in weight loss. It works by stimulating the central nervous system, which increases heart rate and blood pressure and decreases appetite.
Phentermine: Phentermine is a prescription medication used as an appetite suppressant for short-term weight management. It works by stimulating the central nervous system to decrease hunger.
Phentermine and topiramate ER: Phentermine and topiramate ER is a combination medication used for weight management in obese patients. It works by decreasing appetite and increasing feelings of fullness.
Qsymia: Qsymia is a prescription medication that combines phentermine and topiramate to aid in weight loss. It is used in conjunction with a reduced-calorie diet and increased physical activity.
Selective serotonin receptor agonists: Selective serotonin receptor agonists are drugs that specifically target and activate serotonin receptors in the brain to alleviate migraine headaches. They primarily work by narrowing blood vessels and reducing inflammation.
Selective serotonin reuptake inhibitors (SSRIs): Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used primarily to treat depression by increasing serotonin levels in the brain. They work by blocking the reabsorption (reuptake) of serotonin into neurons, making more serotonin available.
Serotonin: Serotonin is a neurotransmitter that plays a crucial role in regulating various physiological and psychological processes in the body. It is involved in the functioning of the nervous system, the regulation of mood, sleep, appetite, and other important bodily functions.
Serotonin Syndrome: Serotonin syndrome is a potentially life-threatening condition caused by an excess of the neurotransmitter serotonin in the body. It can occur as a result of interactions between certain medications or the use of illicit drugs that affect serotonin levels.
SSRIs: SSRIs, or Selective Serotonin Reuptake Inhibitors, are a class of medications primarily used to treat depression and other mental health conditions. They work by selectively inhibiting the reuptake of the neurotransmitter serotonin, which is believed to play a crucial role in regulating mood, sleep, appetite, and other physiological processes.
Sympathomimetic Drugs: Sympathomimetic drugs are a class of medications that mimic the effects of the sympathetic nervous system by stimulating the release or preventing the reuptake of neurotransmitters like norepinephrine and epinephrine. These drugs are often used in the context of anorexiants, as they can suppress appetite and promote weight loss.
Tachycardia: Tachycardia refers to a rapid heart rate, typically defined as a resting heart rate exceeding 100 beats per minute. This abnormally fast heart rhythm can have various underlying causes and is an important consideration in several medical conditions and drug therapies.
Weight Loss Medications: Weight loss medications, also known as anorexiants, are prescription drugs designed to aid in weight reduction by suppressing appetite, increasing feelings of fullness, or altering metabolism. These medications are typically used in conjunction with lifestyle modifications, such as diet and exercise, to help individuals achieve and maintain a healthy weight.