自分用ノート：Pharmacology/体重を増加させる傾向にある薬

勉強ノート

体重を増加させる傾向にある薬（Medications that may cause weight gain）

  • anti-depressant
  • anti-psychotics
  • anticonvulsants
  • antidiabetics
  • mood stabilizers
  • migraine prophylaxis

体重を増加させる傾向にある薬は数多くありますが、主なものをあげてみます。

 

Antidiabetic medication

Insulin or insulin analogues

Short-acting and biphasic (mix of short-acting + intermediate) is more significant than basal insulin, but still basal insulin also induces weight gain and hypoglycemia.

Short-acting

  • Novolog (aspart)
  • Apidra (glulisine) 
  • Humalog (lispro)

Biphasic (Mix of short-acting + intermediate)

  • NovoMix 30
  • Humalog Mix 25 or 50
  • Humulin M3

Intermediate

  • Humalin 
  • Novolin

Basal insulin (24H coverage)

  • Lantus (glargin)
  • Levemir (detemir)
  • Toujeo (glargin)
  • Tresiba (deglude)

NPH – less weight gain, less nocturnal hypoglycemia 

 

Sulfonylureas (-mide, -zide, -ride) – enhance insulin secretion.  

Meglitinide (-linide) –  enhance insulin secretion. Not used with sulfonylureas. No meal -> No med, Extra meal -> Extra med. 

 

Weight loss:

Biguanide/metformin (i.g. Glucophage) – negative weight gain, maybe weight loss

GLP1-receptor agonist (-tide) – cardiovascular benefit (weight loss 10-15 lb!) Liraglutide – S/E include weigth loss, but “Liraglutide” = NOT for pregnant women (category X)

SGLT-2 (-flozin) – protect cardiovascular function (weight loss 5-7 lb) – hypotension, UTI, no for renal

DPP-4 inhibitors (-liptin) – weight neutral (no gain, no loss)

 

 

Antidepressants/ Antipsychotics/ Antiepileptics

tricyclic antidepressant (TCAs) (-ptyline) – has antihistaminergic effect

monoamine oxidase inhibitors (MAOIs)

SSRIs in general – induce carb cravings – paroxetine (Paxil – most significant)

Atypical antidepressant – mirtazapine (Remeron)

Atypical antipsychotics – olanzapine, clozapine. (Risperidone is milder r/t weight gain.) 

lithium (Lithobid, Eskalith) – bipolar med

ADHD med (-dine)

Aripiprazole (Abilify) – LESS weight gain

 

Anticonvulsant:

valproic acid (i.g. Depakote) – for bipolar, migraine prophylactic therapy, seizures 

carbamazepine – bipolar, seizures

Pregabalin (Lyrica), gabapentin– for nerve pain

 

Antihistamines: 

1st generation → more sedative → more CNS effect → more weight gain (cyprohepatadine)

Later generation → less or no weight gain (i.g. Loratadine)

 

Hormonal agents:

Corticosteroids

Oral contraceptives (OC) 

  • progesterone-only contraceptive – medroxyprogesterone (i.g. Depo-Provera, Depo-subQ)
  • Levonorgesterol 

megestrol (Megace) – progestin – for anorexia, person with weight loss, for others

 

 

Cardiac medications: 

Beta-blockers (but carvedilol and nebivolol → LESS weight gain)

Calcium channel blockers – increase edema

 

Antiretroviral therapy  (i.g. -vir)