Duromine - Commencing Treatment

-
Patient requests to commence Duromine
Discussion about indications:
a) BMI >35
b) Health affected by weight:
i. diabetes/ impaired glucose tolerance
ii. raised fasting insulin
iii. high cholesterol
iv. sleep apnoea
v. high cardiovascular risk as a consequence of obesity
FHx of heart disease/ thyroid/ diabetes Y/N
Discussed SEs and rare risks of duromine:
Cardiac: pulmonary hypertension, hypertension, shortness of breath, valvular disorders, chest pain, palpitations, fast heart rate, angina, stroke, heart attack, heart failure, cardiac arrest
CNS disorders:
overstimulation, restlessness, nervousness, insomnia, tremor, dizziness, headache. Euphoria, fatigue, depression, psychosis and hallucinations.
GI system:
Nausea, vomiting, dry mouth, abdominal cramps, unpleasant taste, diarrhoea and constipation.
Renal system:
Urination problems, retention.
Skin:
Rash, swelling
Results
Fasting lipids = NAD
Fasting glucose level =  NAD
TSH = Normal
EUCS/LFTs Normal
Counselled to take daily, check BP and weight at 1/52 and 4/52.
At 3/12 must have lost 5% body to weight to continue.
Take for shortest time as needed. If 5% loss to continue losing 5% per weeks.
To be taken in conjunction with seeing an exercise physiologist and dietician.
Not to be taken during pregnancy or lactation.
Counselled that Duromine can cause lightheadedness and not to drive if symptomatic while on duromine.

Keywords:  Duromine, Phentermine, +duromine

Comments

Post a Comment

Popular posts from this blog

Chest infection

-
Patient presents with a productive cough Generalised Malaise Sputum green in colour Occasional fevers Examination: Respiratory exam: Good Air entry bilaterally No Resp distress CREPITATIONS HEARD Reason for visit: Chest infection Management: Oral Antibioitics as prescribed Patient advised to: - Rest - Regular paracetamol +/- Ibuprofen - Drink plenty of fluids They have been advised to return here or present to ED should their symptoms worsen or if they have any concerns Keywords:  +chestinfection, Penumonia
Read more

Pill Script / OCP / Oral Contraceptive Pill

-
Presents for a refill of her oral contraceptive pill script Has been on this medication for some time without any ill effect No history of - Hypertension - DVT / PE - Migraine with aura Preventiative health screen: Cervical smears up to date Good Diet Exercises regularly Non smoker No concerns about mood Examination: BP:  Reason for contact: Oral contraceptive pill script Management: Script as requested
Read more

STI Check - Aysmptomatic

-
Patient  presents requesting screening testing for sexually-transmitted diseases Patient states they have no symptoms which concern for a STD Counselled patient on the testing that we perform HIV counselling provided and the patient informed that the negative result does not mean that they are clear if they can send I will need to have further testing if they had an exposure which they feel would be high risk for this disease  tests to be performed:  - Gonorrhoea  and chlamydia with first catch urine  -  had HIV, hepatitis C, hepatitis B, syphilis with blood testing serology   herpes simplex testing  was not included as the patient does not have any lesions which were consistent with this disease  advised patient that the best form of protection for STDs is condom is but this would not provide protection against  contracting herpes from her partner who has an active infection  advised patient that if the neither p...
Read more