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Obesity drugs (Phentermine(Adipex-P, Ionamin) (Nursing Considerations…
Obesity drugs
Phentermine(Adipex-P, Ionamin)
Indications
short-term adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity.
patients with an initial body mass index greater than or equal to 30 kg/m2, or greater than or equal to 27 kg/m2 in the presence of the risk factors e.g hypertension,diabetes, hyperlipindemial.
Symphathomimetic amine which reduces body weight by decreasing appetite,increasing the amount of energy used by body or by affecting certain parts of the brain.This is a appetite suppressant drug.
Nursing Considerations
Contraindications
History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive
heart failure, uncontrolled hypertension)
During or within 14 days following the administration of monoamine oxidase inhibitors
Hyperthyroidism
Glaucoma
Agitated states
History of drug abuse
Pregnancy
Known hypersensitivity, or idiosyncrasy to the sympathomimetic amines
Side effects
Stop and consult your doctor
Difficulty breathing
Chest pain
Feeling faint
Swelling in the feet, ankles, and lower legs
serious side effects
Chest, arm, or jaw pain
Very fast heartbeat
Swelling in your feet or legs
High blood pressure
Shortness of breath
Dizziness
Shaking or trembling
Weakness or problems walking
Unpleasant or bad taste in the mouth
Itching, skin redness, or rash
Serious reactions
Upset stomach
Changes in sexual desire or inability to get an erection
Tirelessness or inability to sleep
Problems with thinking
Unusual feelings or behaviors, such as jitteriness, extra sensitivity, an unusual sense of well-being or invincibility (euphoria), or unease or dissatisfaction (dysphoria)
Hallucinations (hearing or seeing things that aren’t there)
Bad taste in the mouth
Become dependent on or addicted to phentermine
Storage and route administration
Tablets may contain a score to allow daily dose to be divided in half and administered before meals or 1 to 2 hours after meals
The usual dose is administered daily before breakfast or 1 to 2 hours after breakfast orally.
KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.
Dispense in a tight container as defined in the USP, with a child-resistant closure (as required).
Store at 20° to 25°C (68° to 77°F)
You should not consume alcohol or any other medication that dulls the nervous system while taking phentermine, since it can work against the desired effects of phentermine.
Phentermine is available in regular and orally dissolving tablets and capsules in a range of strengths, depending on the brand.
It’s important to avoid taking it before 6:00 p.m. because it can cause problems with sleeping.
Missed dose
If you miss a dose of phentermine, try to take it as soon as you remember.
If it’s almost time for the next dose, skip the missed dose and take your next dose at the regular time.
Don't take two doses of the medication at the same time.
Orlistat (Xenical)
Orlistat (Xenical) is a nonsystemic inhibitor of gastrointestinal (GI) lipases that are necessary for the breakdown of fat in the GI tract. The unabsorbable fat is then excreted. Orlistat is a synthetic derivative of lipostatin isolated from a soil bacterium, Streptomyces toxytricini.
Indications
Long-term therapy is indicated for obese patients with a BMI of 30 kg/m2 or greater and for patients with a BMI of 27 kg/m2 who also have diabetes, dyslipidemia, or hypertension.
Nursing Considerations
Contraindications
An eating disorder such as anorexia or bulimia
Type 1 or type 2 diabetes
Kidney stones or kidney disease
Pancreatitis (inflammation of the pancreas)
Gallbladder disease
Thyroid disease
Liver disease
An organ transplant
Cholestasis (a condition where the flow of bile from the liver is blocked)
Malabsorption syndrome (a condition that causes problems with absorbing food)
Side effects
Common side effects
Oily, fatty, or loose stools
Gas with oily spotting
Oily spotting on underwear or clothing
Urgent need to have a bowel movement or an increased number of bowel movements
Stomach pain
Pain in the rectum
Irregular menstrual cycles
Anxiety
Headache
Serious side effects
Hives, rash, or itching
Difficulty breathing or swallowing
Severe stomach pain
Severe fatigue or weakness
Nausea or vomiting
Loss of appetite
Pain in the upper right part of your stomach
Dark-colored urine or bloody urine
Light-colored stools
Yellowing of the eyes or skin (jaundice)
Storage and administration
comes as a capsule and is usually taken three times a day with each meal that contains fat.
Take this medicine during a meal or up to one hour after a meal.
Skip your dose if you miss a meal or if a meal you consume doesn't contain fat.
Follow the instructions on your product label carefully when taking Alli. Don't take more or less of the drug than is recommended.
Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat, moisture (not in the bathroom), and light
Sibutramine (Meridia)
Nursing Considerations
Storage and Administration
Sibutramine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Do not take any other prescription or over-the-counter weight-loss products without your doctor's advice.
Avoid taking cough and cold or allergy medications while taking sibutramine.
Avoid drinking alcohol while taking sibutramine.
Sibutramine is usually taken once daily. Follow your doctor's instructions.
Your doctor may occasionally change your dose to make sure you get the best results.
Sibutramine can be taken with or without food
Store at room temperature away from moisture, heat, and light.
Side effect
less serious
requires emergency medical help
hives
difficult breathing
swelling of your face, lips, tongue, or throat
stop the medication and see the doctor
sudden numbness or weakness (especially on one side of the body), problems with vision, speech, or balance.
chest pain or heavy feeling, pain spreading to the arm or shoulder, general ill feeling; or
dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, seizure);
easy bruising or bleeding (nosebleeds, bleeding gums, or any bleeding that will not stop);
very stiff (rigid) muscles, high fever, sweating, confusion, feeling like you might pass out;
agitation, hallucinations, fever, tremor, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, dilated pupils;
new or worsening shortness of breath;
fast, pounding, or uneven heartbeats;
dry mouth, upset stomach;
changes in appetite;
constipation, stomach pain;
headache, back pain, joint pain;
feeling nervous, dizzy, or depressed;
flu symptoms, runny or stuffy nose, sore throat, cough;
warmth, redness, or tingly feeling under your skin;
trouble sleeping (insomnia); or
mild skin rash.
Contraindications
Hypersensitivity to sibutramine
Concomitant use of centrally acting appetite suppressants
Concomitant monoamine oxidase (MAO) inhibitor use
Anorexia nervosa or bulimia nervosa
Indications
Long-term therapy is indicated for obese patients with a BMI of 30 kg/m2 or greater and for patients with a BMI of 27 kg/m2 who also have diabetes, dyslipidemia, or hypertension.
Sibutramine is a non-amphetamine appetite suppressant that blocks the neuronal uptake of norepinephrine, serotonin, and dopamine.
