Drugs to treat Obesity Orlistat phentermine today, let us discuss various drugs used for the treatment of obesity. Obesity is one of the physiological condition which is associated with excessive body weight, and sometimes we can use another term, overweight. The overweight and obesity are associated with abnormal accumulation of the fat, which results in the increased body weight.
But there is a small difference between these two conditions which can be categorized by using one of the index, Body Mass Index, which is commonly known as BMI. This BMI is the ratio of weight of the person with respect to height of the person. Bmi is the body weight of the person per each square meter of the height, which is measured in the units of kilogram per square meter. This BMI can be used to differentiate the obesity and overweight.
People can be classified as overweight with body mass index greater than or equal to 25 kilograms per square meter. On the other hand, obesity is classified as BMI index greater than or equal to 30 kilo per square meter. With little difference between this BMI, both overweight and obesity indicate some abnormal accumulation of the fat, leading to excessive body weight.
Ideally, the BMI should be maintained less than 25 kilo per square meter. When the BMI of the patient reaches to 30 kilos per square meter, it can be considered as obesity. This obesity may lead to so many systemic complications because of accumulation of the fat. If it is untreated, it may lead to cardiovascular complications resulting in stroke, and it may also result in the accumulation of the cholesterol, which may lead to atherosclerosis, narrowing of the blood vessels with fatty deposition. With excessive body weight, the patient may have high blood pressure. That’s why in order to reduce the blood pressure.
the control of the body weight is one of the important aspect. By reduction of body weight, the blood pressure can be reduced by 5 to 10 millimeter of Mercury. Many of the times, obesity is associated with diabetes. The elevated levels of the blood glucose, which also leads to systemic complications targeting many of the organs, and increase in the effects of obesity. Finally, with increased body weight, there will be more stress on the muscloskeletal system. So obesity may lead to some muscular disorders, resulting in muscle pain, muscle spasm, and muscle weakness. That’s why it is very essential to control the obesity and overweight.
So today in this video, we are going to see what are the different types of drugs used for the treatment of obesity, which are used along with diet control and proper exercise in order to reduce the body weight, to reduce the systemic complications. Now, let us list out the drugs used for the treatment of obesity. We have various drugs like Orlistat, Fentermine, LeraGlutide, Semaglutide. These two drugs are belonging to the same category because they’re having the same suffix, Glutide.
Similarly, we can use the combination of the drugs. We have the well known combination, Naltrexone plus Bupropion. This combination can be used for the management of obesity along with diet control and exercise. And Fentermine can also be combined with and the drug Topiramamate.
This Topiramamate is one of the antiapileptic agent. So this antiapileptic agent can be combined with Fentermine to produce control on the appetite and food intake. Now, let us go one by one and let us discuss the different types of drugs, how they work, what are the important side effects, and doses of these medications. Let us start with the first one, Orlistat. Orlistat is one of the lipase inhibitor. Within the name of this drug, we can observe the suffix STAT.
The STAT indicates it inhibits the enigmatic activity. All STAT inhibits gastric as well as pancreatic lipase activity. This drug acts as a reversible lipase inhibitor so that when out this drug is going to be stopped, again, the lipase activity can be restored, which is required after the stopping of the therapy.
This drug, by blocking the lipase activity, it inhibits the breakdown of the triglycerides into free fatty acids. By intake of fatty food, the fat is going to be absorbed into the systemic circulation, but allogesthat can reduce the absorption of free fatty acids. Thereby, it controls the body weight. So this drug can be given along with the diet control and proper exercise to control the obesity.
This drug can act on the duodenum where triglycerates are going to be normally absorbed. Here, lipase is one of the important enzyme which acts on the triglycerides so that it produce a breakdown of the triglycerides into free fatty acids. These free fatty acids are going to be absorbed into the systemic circulation. Now, this step is going to be blocked by allistat. Allistat inhibits the lipase activity such that it inhibits the breakdown of the triglycerides. Therefore, trichlorides are not absorbed.
Instead, they are excreted within the feces. This reduces the fatty deposition, thereby it reduce the body weight in the patients. This allogestate can be given at a dose of 120 mg given twice daily. This drug, because of decreased trichloride absorption, it can produce few of the side effects such as fecal urgency, oil spotting, and Oils tools can be observed with the use of Olistat. On long term therapy, Olistat can also develop the renal stones where care should be taken to avoid the nephrolithiasis, the formation of renal stones in the patients.
Second drug is the Fentermine. Fentermine is classified as an anorexic agent. This drug acts as a sympathomimetic. And then the drug within this category is the Diethylpropion. Both of these drugs are classified as anorexic agents which reduce the appetite. And these drugs are amphetamine derivatives. That’s why they can act as sympathomimedics. So they can stimulate the sympathetic system.
And because of increased sympathetic activity within the CNS, they can reduce the appetite, which reduce the intake of food, thereby it reduces the body weight. Within the hypothalamus, norepinephrine plays an important role to control the appetite. Now, fentermine acts as amphetamine. It can be taken to the nerve terminal through the norepinephrine transporter, where for exchange of fentermine, one of the norepinephrine is going to be leaked out and it acts on post synaptic receptors.
In this way, fentermine can increase the release of norepinephrine into the synaptic cleft, which increase the transmission of norepinephrine. Thereby, it reduces the appetite within the hypothalamus. So Fentermine is a sympathomimetic which reduces the appetite by increasing the noradrenergic transmission within the hypothalamus which controls the appetite centers. This Fentermine should be taken before the breakfast and it can be given at a dose of 37.5 mg in the form of phentermine hydrochloride.
This 37.5 mg phentermine hydrochloride is equivalent to 30 mg of free base Fentermine. In the salt form, the dose is somewhat different. It is given as 37.5 mg. Since this drug acts as a symptom mactic, this drug can produce effects of sympathetic system. So phentermine can produce the elevated blood pressure. It can also increase the heart rate, resulting in tachycardia.
It can increase the palpitations, awareness of heartbeat. And on long term, this phentermine can also increase the value allopathy. It can produce the inflammation of the cardiac walls, which may reduce the functionality of the heart. But rarely this drug can produce the value allopathy. The common side effects observed with Fentermine is the elevated blood pressure and tachycardia. And already we have discussed that phentermine can be combined with another drug, Topiramate.
Topiramate is an antiapellactic agent, but this drug can be combined with phentermine to reduce the appetite. In this combination, phentermine is given at a dose of 7.5 mg and Topiramate is given at a dose of 46 mg, which is the recommended combination of these drugs to control the body weight. Third one is the liraglutide. Liraglutide is one of the GLP1 receptor agonist, glucagon like peptide 1 receptor agonist.
We have another drug, semaglutide, which is having the same suffix, Glutide. These drugs are high in few of the advantages. They can bind to albumin so that they are somewhat long acting and they are given as subcutaneous injections. Normally, glucagon like peptides are metabolized by DPP4 enzyme, dipeptidylpeptidase 4 enzyme.
But liraglutide and semaglutide are not metabolized by DPP4 enzyme. So they are having high bioavailability. Because of all these advantages, liraglutide and semaglutide are nowadays one of the good drugs to control the body weight. These drugs can also reduce the excessive glucose levels, so they can be used as anti diabetic agents as well as they can also reduce the excessive body weight and they can also reduce cardiovascular complications. Because of all these beneficial effects.
