32.4 Other Drugs, Supplements, and Herbal Remedies

Weight loss supplements and prescription drugs offer potential solutions for those struggling with obesity. From over-the-counter herbal remedies to FDA-approved medications, these products aim to suppress appetite, block fat absorption, or boost metabolism.

However, efficacy and safety concerns exist. Many supplements lack strong scientific evidence, while prescription drugs can cause side effects. Nurses play a crucial role in educating patients about proper use, monitoring for interactions, and promoting healthy lifestyle changes alongside medication.

Weight Loss Supplements and Herbal Remedies

Efficacy and safety of over-the-counter weight loss supplements and herbal remedies

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• Over-the-counter weight loss supplements and herbal remedies often lack strong scientific evidence supporting their efficacy may lead to modest short-term weight loss (green tea extract, garcinia cambogia) but long-term effectiveness is not well-established
• Safety concerns exist with certain weight loss supplements and herbal remedies some products contain stimulants or other ingredients that can cause adverse effects increased heart rate and blood pressure, insomnia, digestive issues (bloating, diarrhea), anxiety and irritability herbal remedies may interact with prescription medications (warfarin, antidepressants) or exacerbate underlying health conditions (hypertension, diabetes)
• Regulation of dietary supplements is less stringent than prescription drugs supplements do not require FDA approval before marketing quality control and consistency of ingredients may vary between products

Mechanisms of action and side effects of prescription weight management drugs

• Prescription weight management drugs work through various mechanisms to promote weight loss
  1. Appetite suppression phentermine (Adipex-P, Lomaira) and diethylpropion (Tenuate) stimulate the release of norepinephrine, reducing hunger
  2. Nutrient absorption inhibition orlistat (Xenical, Alli) blocks the absorption of dietary fat in the intestines by inhibiting pancreatic lipase
  3. Combination therapies phentermine/topiramate (Qsymia) suppresses appetite and increases feelings of fullness naltrexone/bupropion (Contrave) reduces appetite and food cravings by acting on brain reward systems
• Potential side effects of prescription weight management drugs include gastrointestinal issues (nausea, diarrhea, constipation), dry mouth, insomnia, dizziness, headache, increased heart rate and blood pressure (with stimulant-based medications)

Nursing Interventions and Patient Education

Nursing interventions and client education for patients using weight loss medications or supplements

• Assess patient's medical history, current medications, and lifestyle habits before recommending weight loss products
• Educate patients on the importance of a balanced diet and regular physical activity in conjunction with weight loss medications or supplements
• Instruct patients to follow dosage instructions carefully and report any adverse effects to their healthcare provider
• Monitor patients for potential side effects and drug interactions regularly check vital signs, especially in patients taking stimulant-based medications assess for signs of nutrient deficiencies (vitamin A, D, E, and K) in patients taking orlistat
• Encourage patients to set realistic weight loss goals (0.5-1 kg per week) and maintain a positive body image
• Provide resources for long-term weight management and behavior modification strategies (meal planning, stress management)
• Emphasize the importance of regular follow-up visits to assess progress and adjust treatment plans as needed

Interactions between weight management products and other medications or health conditions

• Weight loss medications and supplements can interact with other drugs, altering their effectiveness or increasing the risk of adverse effects stimulant-based weight loss drugs may interact with antidepressants (SSRIs, SNRIs), leading to serotonin syndrome orlistat can reduce the absorption of fat-soluble vitamins and certain medications (cyclosporine, levothyroxine)
• Certain health conditions may contraindicate the use of specific weight loss products
  • Cardiovascular disease stimulant-based medications may exacerbate hypertension and arrhythmias
  • Diabetes weight loss drugs may affect blood glucose levels and require adjustments to antidiabetic medications (insulin, metformin)
  • Thyroid disorders stimulant-based medications may worsen hyperthyroidism symptoms
  • Gastrointestinal conditions (inflammatory bowel disease, gallbladder disease) orlistat may exacerbate these conditions or increase the risk of complications
• Consult with a pharmacist or physician to identify potential drug interactions and contraindications before starting weight loss medications or supplements