This document summarizes several medications used to treat obesity and related comorbidities such as diabetes. It describes the mechanism of action, efficacy, dosing, and adverse effects of medications including metformin, pramlintide, exenatide, liraglutide, bupropion, topiramate, phentermine, lorcaserin, phentermine/topiramate, orlistat, and naltrexone/bupropion. Clinical trials have shown these medications can promote weight loss ranging from 2-10% of initial body weight when used as an adjunct to diet and exercise. Common adverse effects include nausea, vomiting, diarrhea, constipation, and changes in
Our aim is to reduce morbidity and mortality related to Non communicable diseases such as hypertension, diabetes, cardiovascular disease, stroke, Obesity, Cancer and lifestyle diseases among those least able to withstand the burden of the disease.
Our aim is to reduce morbidity and mortality related to Non communicable diseases such as hypertension, diabetes, cardiovascular disease, stroke, Obesity, Cancer and lifestyle diseases among those least able to withstand the burden of the disease.
This Presentation Give You A brief Information About DPP4 And New Recommendations .This Presentation Guide You How To Treat Patients With Safety.
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Glimepiride Tablets USP 1mg, 2mg, 3mg, 4mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Glimepiride Dosage & Rx Info | Glimepiride Uses, Side Effects Glimepiride: Indications, Side Effects, Warnings, Glimepiride-Drug Information –Taj Pharma, Glimepiride dose Taj pharmaceuticals Glimepiride interactions, Taj Pharmaceutical Glimepiride contraindications, Glimepiride price, Glimepiride Taj Pharma Glimepiride SmPC- Taj Pharma Stay connected to all updated on Glimepiride Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SMPC.
Interested in learning more about Metformin, here's all you need to know!
Brought to you by the MedSimple Team.
MedSimple is a unified medication management platform designed to help patients two or more meds through the following features:
• 1. A Med List to document prescribed and over-the-counter medications, dosage, frequency and strength
• 2. A customizable list of prescribers and pharmacies
• 3. Cost savings via coupons (Premium feature)
• 4. Generic Alternatives: Links to information about generic alternatives, fixed price (such as $4) lists
• 5. Long-term cost savings via Patient Assistance Programs and forms for requesting assistance (Premium feature)
• 6. Dosage reminders (such as alarms and notifications)
• 7. Refill reminders for picking up prescriptions prior to refill dates (Premium feature)
• 8. Drug information and complete look-up on drug side affects, interactions, warnings and more
• 9. Ready-to-use digital MedSimple Drug Discount Card
• 10. Access to and synchronized data with browser-based partner site, MedSimpleApp.com
Zita-Met (Generic Sitagliptin Phosphate Monohydrate and Metformin Hydrochloride Tablets) helps to lower blood sugar levels in patients with type 2 diabetes mellitus along with diet and exercise.
Zita-Met tablets can be used alone, or in combination with Ertugliflozin, Insulin, or Sulfonylurea medicines such as Glimepiride, Gliclazide and Glibenclamide.
Achieving Hba1c targets: Strategies For Initiating and Intensifying Diabetes ...Nemencio Jr
This module highlights the appropriate HbA1c targets that reduce microvascular and macrovascular complications in appropriate populations and how to safely achieve them with current anti-hyperglycemic agents
EFFECTIVE TACTICS OF CONTENT MARKETING FOR THE ENTIRE SALES FUNNEL
About the strategic and practical direction in which all parts of your organization should be headed.
HOW CLOSE ARE YOU TO THE FUTURE? A NEW WAY OF LOOKING AT CONTENT MARKETING
The transformation of communications departments both within companies and organizations and externally. What will the new type of person, and their competences, be like? What kinds of processes and technologies will make up the communications departments of the 21st century? Why can we not afford to avoid or overlook this?
This Presentation Give You A brief Information About DPP4 And New Recommendations .This Presentation Guide You How To Treat Patients With Safety.
For Further Contact:03354999496
Glimepiride Tablets USP Taj Pharma SmPCTajPharmaQC
Glimepiride Tablets USP 1mg, 2mg, 3mg, 4mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Glimepiride Dosage & Rx Info | Glimepiride Uses, Side Effects Glimepiride: Indications, Side Effects, Warnings, Glimepiride-Drug Information –Taj Pharma, Glimepiride dose Taj pharmaceuticals Glimepiride interactions, Taj Pharmaceutical Glimepiride contraindications, Glimepiride price, Glimepiride Taj Pharma Glimepiride SmPC- Taj Pharma Stay connected to all updated on Glimepiride Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SMPC.
Interested in learning more about Metformin, here's all you need to know!
Brought to you by the MedSimple Team.
MedSimple is a unified medication management platform designed to help patients two or more meds through the following features:
• 1. A Med List to document prescribed and over-the-counter medications, dosage, frequency and strength
• 2. A customizable list of prescribers and pharmacies
• 3. Cost savings via coupons (Premium feature)
• 4. Generic Alternatives: Links to information about generic alternatives, fixed price (such as $4) lists
• 5. Long-term cost savings via Patient Assistance Programs and forms for requesting assistance (Premium feature)
• 6. Dosage reminders (such as alarms and notifications)
• 7. Refill reminders for picking up prescriptions prior to refill dates (Premium feature)
• 8. Drug information and complete look-up on drug side affects, interactions, warnings and more
• 9. Ready-to-use digital MedSimple Drug Discount Card
• 10. Access to and synchronized data with browser-based partner site, MedSimpleApp.com
Zita-Met (Generic Sitagliptin Phosphate Monohydrate and Metformin Hydrochloride Tablets) helps to lower blood sugar levels in patients with type 2 diabetes mellitus along with diet and exercise.
Zita-Met tablets can be used alone, or in combination with Ertugliflozin, Insulin, or Sulfonylurea medicines such as Glimepiride, Gliclazide and Glibenclamide.
Achieving Hba1c targets: Strategies For Initiating and Intensifying Diabetes ...Nemencio Jr
This module highlights the appropriate HbA1c targets that reduce microvascular and macrovascular complications in appropriate populations and how to safely achieve them with current anti-hyperglycemic agents
EFFECTIVE TACTICS OF CONTENT MARKETING FOR THE ENTIRE SALES FUNNEL
About the strategic and practical direction in which all parts of your organization should be headed.
HOW CLOSE ARE YOU TO THE FUTURE? A NEW WAY OF LOOKING AT CONTENT MARKETING
The transformation of communications departments both within companies and organizations and externally. What will the new type of person, and their competences, be like? What kinds of processes and technologies will make up the communications departments of the 21st century? Why can we not afford to avoid or overlook this?
ŠTUDIJA PRIMERA: ŠKODA – CELOSTNI POGLED V PRAKSI – VSEBINSKO IN DIGITALNO
Možnosti in nove priložnosti integriranega vsebinskega marketinga so neskončne in, kar je najlepše, … dejansko delujejo (= prodajajo)!
Statements of accomplishment from:
- Ecole CentraleSupélec
http://www.supelec.fr/374_p_14603/welcome.html
- Le Cnam
http://the.cnam.eu
- AgroParisTech
http://www.agroparistech.fr/Presentation-of-AgroParisTech.html
- UVED
http://uved.fr/navigation/accueil.html
- Johns Hopkins University
https://www.jhu.edu/
- The University of Texas Health Science Center at Houston School of Public Health
https://sph.uth.edu/
- Université de Nantes
http://www.univ-nantes.fr/33496937/1/fiche___pagelibre/&RH=INSTITUTIONNEL_FR&RF=INSTITUTIONNEL_EN
- Centrale Lille
http://www.ec-lille.fr/en/index.html
- ISIPCA
https://www.isipca.fr/en
“NATIVE ADVERTISING”: THE QUALITY OF CONTENT IS KEY
Why is the role of native advertising more and more important? Where is its place within the overall strategy of content marketing? Where are the traps and dangers and how should you start?
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A short lecture highlighting the most important aspects of pharmacological management of DM in general. It discusses the use of insulin in type I diabetes mellitus and the approach with hypoglycemic agents in type II.
gestational diabetes is a condition of diabetic symptoms for a short period of time during the pregnancy, which may be fatal or complicated for both mother and fetus.
1. 1
Treatment of Obese Patients with Comorbidities
Medication MOA Efficacy Dosing Adverse Effects
Diabetes Mellitus
Metformin -Biguanide: reduces
hepatic glucose
production, decreases
intestinal glucose
absorption from the
GI tract, and enhances
insulin sensitivity
- Diabetes Prevention
Program (double-blind
placebo controlled): loss
at 2.8 years metformin
group 2.9 kg vs. placebo
group 1.04 kg
- Weight loss is directly
related to adherence
-Weight loss persisted
during the eight year
follow up period in the
most adherent patients
-Initiate 500 mg QD-
BID
-Titrate by 500 mg/day
weekly
-Max dose 2,550 mg/day
-Max effective dose in
diabetes 2,000 mg/day
-Diarrhea
-Nausea and
vomiting
Pramlintide -Synthetic form of
amylin
-Reduces caloric
intake through
centrally-mediated
appetite suppression
- A six month clinical
trial showed additive
weight loss when
added to phentermine.
-Initiate 60 mcg SC
immediately prior to
major meals
-Increase dose to 120
mcg after 3 days
-Decrease dose to 60
mcg with severe nausea
-Nausea
-Hypoglycemia
-Anorexia
Byetta (exenatide) -Glucagon-like
peptide-1 receptor
agonist
-Slows gastric
emptying
-Decreases food intake by
19%
-Systematic review showed
a weight loss of 2.37 kg for
all GLP-1 agonists
-1.44 kg vs.placebo; 4.76
kg vs.insulin
-26 week randomized
control trial resulted in
weight loss of 2.3 kg for the
exenatide group vs.a 1.8 kg
gain in insulin glargine
group.
Immediate Release
-Initiate 5 mcg BID 60
min prior to meals
-Increase to 10 mcg BID
based on diabetic
response
Extended Release
-2 mg once weekly
-Headache
-Nausea and
vomiting
2. 2
Victoza (liraglutide)
Saxenda (liraglutide)
-Glucagon-like
peptide-1 receptor
agonist
-Saxenda is FDA
approved for weight
loss
-20 week European
trial evaluated various
daily doses and weight
loss effect: 1.2 mg (4.8
kg), 1.8 mg (5.5 kg),
2.4 mg (6.3 kg), 3.0
mg (7.2 kg) vs. 2.8 kg
in the placebo group
vs. 4.1 kg in the orlistat
group
-76% of 3.0 mg
treatment group
achieved >5% weight
loss
Chronic Weight
Management:
-Initiate 0.6 mg SC QD
for one week
-Increase dose by 0.6 mg
weekly to a target 3.0
mg
Diabetes Treatment:
-Initiate 0.6 mg SC QD
for one week
-Increase to 1.2 mg QD
-Max 1.8 mg QD
-Headache
-Nausea and
vomiting
Depression, Epilepsy, Migraine
Bupropion
-Inhibitor of
norepinephrine and
dopamine reuptake
-Reduces food intake
by acting on
adrenergic and
dopaminergic
receptors in the
hypothalamus
-Reduced body weight
by 6.2% (300 mg/day)
and 7.2% (400
mg/day)
-Dose varies based on
comorbidity and salt
form
-Tachycardia
-Headache
-Agitation
Topiramate
-Reduces appetite by
enhancing GABA
activity
-n=385 patients
randomized to five
groups (64 mg/d, 96
mg/d, 192 mg/d, 384
mg/day, or placebo)
resulted in weight loss
of 7.3% of initial
weight at six months
-Weight loss is dose
related
-Dose varies based on
comorbidity
-Used in combination
with phentermine for
weight loss:
Phentermine/Topiramate
3.75/23 mg (initial),
7.5/46 mg
(recommended), 15/92
mg (max)
-Paresthesias
-Somnolence
-Difficulty with
concentration,
memory, and
attention
3. 3
Current Drugs Approved for Treatment of Obesity
Medication MOA Efficacy Dosing/Monitoring Adverse Effects
Phentermine
-Phentermine is a
sympathomimetic amine
producing CNS
stimulation.
-The mechanism by
which it produces
weight loss is primarily
by appetite suppression.
-First approved by the
FDA in 1959.
-Weight loss at 6 months
with Phentermine 15 mg
was 4.6% of total body
weight (n=756), and 8.1
+/- 3.9 kg at 12 weeks
(n=37).
Short-term:
-15-30 mg PO QD
-18.75 mg PO BID
-37.5 mg PO BID
-Increased blood
pressure
-Increased heart
rate
-Appetite
suppression
-Xerostomia
-Insomia
-Irritability
-Nervousness
Belviq (lorcaserin)
-Selectively targets
and binds to the
serotonin 2c receptors
(agonist), thereby
promoting satiety and
decreased food intake.
BLOOM, BLOSSOM,
BLOOM-DM enrolled
patients with a BMI of
>/= 27. At 48 weeks,
weight loss was ~10 kg
in the lorcaserin group,
and weight
maintenance was
demonstrated versus
placebo.
-HbA1c decreased by
0.9 +/- 0.06, FBG
decreased by 27.4 +/-
2.5 mg/dL.
-10 mg PO BID
-Discontinue at 12
weeks of therapy if only
</= 5% weight loss
-Contraindicated in
pregnancy.
-Monitoring for potential
development of
valvulopathy.
-Nausea
-Dizziness
-Fatigue
-Heart valve
disorder
-Hypoglycemia
-Suicidal ideation
-Serotonin
syndrome when
used with SSRIs
or MAOIs
4. 4
Qsymia (phentermine/
topiramate ER)
-Dual mechanism of
appetite
suppression/decreased
food intake, and
increased satiety via
enhanced
catecholamine release.
-EQUIP and
CONQUER trial
reported weight losses
approaching 10%, and
maintained weight loss
of 9.3% below baseline
at the end of two years
at 7.5/46 mg. Patients
taking 15/92 mg
maintained 10.7%
weight loss after two
years.
-Improvements in
cardiovascular risk
factors, such as blood
pressure, triglycerides,
and blood glucose.
- 3.75/23 mg QAM for
14 days, then increase to
7.5/46 mg QD.
-Evaluate weight loss at
12 weeks of therapy, and
discontinue or escalate
the dose if <3% weight
loss.
-To escalate the dose
increase phentermine
dose to 11.25/69 mg for
14 days, then 15/92 mg
for 12 weeks.
-If <5% weight loss,
gradually discontinue.
-Paresthesias
-Dizziness
-Dysgeusia
-Insomnia
-Constipation
-Xerostomia
-Negative
pregnancy test
before and during
treatment, as
topiramate is
associated with a
risk of oral cleft in
the developing
fetus.
Orlistat
(tetrahydrolipstatin)
-Orlistat is a selective
inhibitor of lipases in
the stomach and
intestines that
ultimately reduces the
intestinal digestion of
fat.
-539 adolescents
received 120 mg TID
with a mean net weight
loss -2.87 kg (-3.21 to -
2.53) 95% CI.
-120 mg PO TID
(prescription)
-60 mg PO TID (OTC)
-Recommended to eat a
balanced diet containing
at least 30% calories
from fat.
-Fecalfat loss and
increased urge to
defecate
-Small decreases in
fat soluble vitamins
-Rare cases of
idiosyncratic liver
injury.
Contrave
(naltrexone/bupropion)
-Reduction of food
intake by inhibiting
the reuptake of
dopamine and
norepinephrine,
increasing firing in the
appetite control
center.
-Weight loss at one
year with this
combination was
intermediate between
Qsymia and Belviq.
-No increase in
cardiovascular events
to date.
-Initial dose escalation,
naltrexone 8 mg/bupropion
90 mg (1 tablet) PO QAM
for week 1; then 1 tablet
twice daily, QAM and
QPM,for week 2; then 2
tablets QAM and 1 tablet
QPM for week 3;
maintenance dose, week 4
and thereafter,2 tablets PO
BID, for a total daily
dosage of naltrexone 32
mg/bupropion 360 mg
- Daily doses greater than
naltrexone 32
mg/bupropion 360 mg not
recommended.
-Assess weight loss at 12
-Increased blood
pressure
-Increased pulse