According to the clinical history presented by Ms. Whitley, a 26-year-old female, I would recommend that she use Albuterol to manage asthma. Besides, I will recommend that the patient continues with acetaminophen for the management of knee pain. Therefore, the following case study will provide for the effective medication recommendations Ms. Whitley should use so that she loses the 20 lbs. she gained in college.
Overweight (obesity) and diseases associated with increased weight, including diabetes and hypertension, and gastroesophageal disease (GERD), have been described to exacerbate the symptoms and risks of asthma. Thus, prescription weight pills are crucial for reducing asthmatic symptoms.
I would recommend that she use the phentermine-topiramate medication pill. The medication combines the two drugs, phentermine which belongs to the class known as anorectics, and Topiramate, which belongs to anticonvulsants. Qsymia is the generic and trade name for the phentermine-topiramate medication. The initial dose is 3.75 mg/23mg PO qDay for 14 days. The rationale for the drug is that this combination is that it will provide for improved tolerability and efficacy (Johnson & Quick, 2018). This combinatory medication pill is highly effective for weight loss since it incorporates both the adrenergic agonists with a neuro stabilizer; hence it will potentiate collective management of asthma and loss of the gained weight.
Potential Side Effects and Drug Interactions
The medication combination of phentermine-topiramate drugs contributes to different magnitudes of side effects. Symptoms are sometimes severe, and the patient should notify the doctor once the adverse effects persist. The patient may complain of abnormal sensations, mild, moderate, or severe headaches, alteration of taste, and mouth dryness (Lei et al., 2021). Besides, additional side effects include insomnia, constipation, dizziness, tightening of muscles, abnormal pain in the muscles, legs, arms, and back. The patient may also experience difficulties concentrating, speaking, thinking, excessive tiredness, heartburns, painful menstrual periods, and diarrhea. The patient may need emergency medical treatment whenever serious side effects such as racing heartbeat are prolonged for several minutes, redness and eye pain, sudden vision decrease, and blood in the urine.
Prescribing phentermine-topiramate medications have different magnitudes of contraindications following their interactions with Monoamine Oxidase (MAO) inhibitors after 14 days of administration. This drug interaction can be fatal. MAO inhibitors such as isocarboxazid, and linezolid, for example, should be avoided since they cause severe interactions with the phentermine-topiramate medications (Xing et al., 2017). It is recommended that MAO inhibitors be should not be administered to patients for two weeks before treatment with the phentermine-topiramate drug. Besides, contraindications occur when CNS Depressant drugs such as barbiturates and benzodiazepines interact with the phentermine-topiramate medication. This drug interaction results in cognitive adverse reactions, including dizziness and depression side effects.
Non-Pharmacological Interventions for Weight management
I would use therapies that combine diets, exercises, and cognitive-behavioral interventions. Dietary approaches will be aimed at reducing calories as well as practicing healthier eating habits. This will allow for steady weight loss. Also, nutritional interventions include cutting calories, feeling full on less, restricting certain foods and meal replacement, and making healthier choices. Increasing physical exercises and activities will be an essential part of managing weight. Exercising for 150 minutes per week will lead to a modest loss of weight. The cognitive-behavioral change includes making lifestyle changes that will be crucial in losing weight. Counseling through interaction with a professional in mental health will help the patient cope with emotions and behaviors related to appetite and eating.
Patient education on Weight Management
Weight management requires education to the patient to ensure success in losing weight. I would educate the patient to make regular exercises part of their daily routine since progressive weight management will be achieved (Acosta et al., 2017). Besides, having a regular check for BMI will also provide for evaluating whether the patient is losing weight or not.
Conclusively, phentermine-topiramate (Qsymia) is the most effective and has improved tolerability in weight loss. However, this combination has many side effects and different degrees of contraindication following the interaction with other drugs, especially the MAO Inhibitors. Non-pharmacological interventions such as dietary, exercise, and cognitive behavior changes will be effective in weight loss. Therefore, to avoid the side effects of weight loss pills, I would recommend non-pharmacological interventions with fewer side effects.
Acosta, A., Streett, S., Kroh, M. D., Cheskin, L. J., Saunders, K. H., Kurian, M., … & Aronne, L. (2017). White paper AGA: POWER—practice guide on obesity and weight management, education, and resources. Clinical gastroenterology and hepatology, 15(5), 631-649.
Johnson, D. B., & Quick, J. (2018). Topiramate and phentermine.
Lei, X. G., Ruan, J. Q., Lai, C., Sun, Z., & Yang, X. (2021). Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta‐Analysis. Obesity, 29(6), 985-994.
Xing, S., Sharp, L. K., & Touchette, D. R. (2017). Weight loss drugs and lifestyle modification: Perceptions among a diverse adult sample. Patient education and counseling, 100(3), 592-597.