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Insulin Action and Its Disturbances in Disease - part 10

Sibutramine là một đường uống trực thuộc Trung ương hoạt động quản lý đại lý trọng lượng. Nó dường như không có tiềm năng lạm dụng thuốc kích thích giống như. Các chính 54 505 (BTS) và trung học 54 354 (BTS) chất chuyển hóa amine của sibutramine có hoạt tính dược lý và được cho là để tạo ra | 542 THERAPEUTIC STRATEGIES FOR INSULIN RESISTANCE range although these levels were lower than those of placebo-treated patients in some trials. It is therefore recommended the diet should be rich in fruit and vegetables. In addition to this NICE has recommended that the patient should have already lost 2.4 kg by diet and exercise prior to starting orlistat their BMI should be above 30 kg m2 or 28 kg m2 if they have other co-morbidities. Patients should receive appropriate dietary advice from health professionals. Continuation of treatment beyond 3 months should be accompanied by a weight loss of five per cent from the initial body weight and beyond six months by a loss of 10 per cent.38 39 Sibutramine Sibutramine is an orally administered centrally acting weight management agent. It is apparently devoid of amphetamine-like abuse potential. The primary BTS 54 505 and secondary BTS 54 354 amine metabolites of sibutramine are pharmacologically active and are thought to induce the natural processes leading to the enhancement of satiety and thermogenesis by inhibiting serotonin and noradrenaline re-uptake. The pharmacological activity of sibutramine does not appear to be a result of increased serotonin release this differentiates it from the action of dexfen-fluramine which predominantly causes the release of serotonin and dexamphetamine which predominantly releases dopamine and noradrenaline. This may account for the lack of abuse potential with sibutramine.40 The drug undergoes first pass metabolism to form pharmacologically active primary M1 and secondary M2 metabolites. In trials steady state plasma metabolite concentrations were maintained throughout treatment.41 Plasma concentrations of sibutramine and its metabolites are unaffected by the presence of renal dysfunction.42 However sibutramine is contraindicated in patients with significant hepatic dysfunction. In most trials sibutramine was administered with a reduced calorie diet and activity advice. Trial data .