Question

1. In the US, a large number of individuals are overweight and many are considered to be obese.  It is conventional wisdom that to lose weight, one needs to eat less and move more. However, it doesn’t appear to be so simple in practice.  Pharmaceutical companies have been searching for weight loss pills for some time but the currently approved medications are very limited.
   1. Compare and contrast the FDA approved orlistat and lorcaserin.
2. 2. A number of weight loss drugs have been pulled from the market.  Investigate one of these drugs and provide its mechanism of action and reason for being removed from the market.

1. Mr Goodman has stage 2 hypertension and has been prescribed chlorothiazide and Lisinopril for several years.  His blood pressure reads 155/97. Upon questioning, he admits that she usually only takes the diuretic and skips the other drug since it is so expensive.
   1. What should you tell Mr Goodman?
2. 2. Is there anything that could be done to increase his drug compliance?

1. There are many different types of diuretics.  Please answer the following in regards to these diuretics.
   1. How does the mechanism of action of the osmotic diuretics differ from that of other diuretic drugs?  
2. 2. What adverse effects are common to both thiazides and the organic acid [loop] diuretics?
3. 3. How can acetazolamide produce metabolic acidosis?

Answer 1

1) a)

Feature	lorcaserin	orlistst
Brand name	belviq	xenical, alli
Mechanism of action	serotonin Receptor agonist	reversible inhibition of gastric and pancreatic lipases
Outcome	Reduces appetite	reduces fat absorption
Dose	10mg twice daily	xenical-120mg three times daily Alli- 60mg three times daily
Side effects	headache, dizziness, dry mouth,constipation, nausea, fatigue	borboygmi, flatus, loose stools, fat spoting per rectum, abdominal cramps
	Recommended for cardiovascular disease patients	recommended by FDA for cardiovascular disease patient

B) Oxilofrine: MOA:

- sympathomumetic drug

-acts on alpha 1adrenergic receptors

- stimulant

Side effects:

Arrythmia,

Cardiac arrest

High BP

2.a) educate him about the complications of raised BP and the expensive will be morer than this

B) try changing the drug or brand which is affordable by him

3a) The osmotic diuretics act in the proximal tubule and in the loop of Henle. By absorbing water from the intracellular compartment, and increase ECF volume and renal blood flow.

Increased medullary blood flow dilute the urine by acting on medulla

B) adverse effects common to both thiazide and loop diuretic

- electrolyte imbalance, hypokalemia, hypomagnesimia,

-hyperuricemia( increased uric acid in blood)

C) by inhibiting the reabsorption of bicarbonate ions from kidney