肥胖的药物治疗原则.ppt

0115010821 Ballantyne MD Principles of Pharmacotherapy in the Management of Obesity Drugs Approved by FDA for Treating Obesity Effect of Continuous and Intermittent Phentermine Therapy on Body Weight Orlistat Prevents Fat Digestion and Absorption by Binding to Gastrointestinal Lipases Effect of Orlistat Dose on Fecal Fat Excretion Effect of Long-term Orlistat Therapy on Body Weight Meta-analysis of RCTs Evaluating Effect of Orlistat Therapy on Weight Loss at 1-Year Independent Effect of Orlistat on Plasma LDL-Cholesterol Orlistat Inhibits Dietary Cholesterol Absorption Gastrointestinal Side Effects of Orlistat Therapy Case Report of Effect of Orlistat on Blood Cyclosporin A Concentration Sibutramine Blocks Neuronal Monoamine (Serotonin, Norepinephrine, Dopamine) Reuptake Effect of Continuous vs Intermittent Subutramine Therapy on Body Weight Initial Responders to Sibutramine Can Maintain Long-term Weight Loss Use of Sibutramine within a Health Maintenance Organization Enhances Weight Loss Meta-analysis of RCTs Evaluating Effect of Sibutramine Therapy on Weight Loss at 1-Year Adverse Effects of Sibutramine Therapy Blood Pressure and Pulse Rate After 1 Year Sibutramine Therapy in Patients with Controlled Hypertension Additive Effects of Behavior and Diet Therapy with Pharmacotherapy for Obesity Sibutramine blocks neuronal monoamine (serotonin, norepinephrine, dopamine) reuptake Sibutramine is a derivative of the amphetamine precursor β-phenylethylamine that has been chemically modified to eliminate its abuse potential. Sibutramine enhances satiation (level of fullness during a meal), by blocking the reuptake of monoamine neurotransmitters (serotonin, norepinephrine, and to a lesser extent, dopamine) in the hypothalamus. Monoamines, synthesized by presynaptic neurons, are stored in granules that release their contents into the cleft between pre- and postsynaptic nerves. Most of the monoamines released into the interneuronal cleft are taken back up by the presynaptic