Based on anorectic efficacy data, sibutramine, a serotonin-norepinephrine reuptake-inhibitor, is a viable therapeutic option for the treatment of obesity. Recommended candidates for this medication are patients with a body mass index (BMI) > or = 30 kg/m2 without concomitant risk factors or patients with a BMI > or = 27 kg/m2 with concomitant risk factors. Sibutramine should be used with caution in patients with a history of hypertension and should not be used in those with uncontrolled hypertension and concomitant cardiovascular disease. Further studies need to be conducted in order to identify long-term outcomes beyond one year.
Angiotensin-converting enzyme (ACE) inhibitors are widely administered to treat numerous medical conditions. Although they are generally well tolerated, they are associated with a dry cough that can lead to discontinuation of treatment. Data concerning the frequency, onset, and clinical effects vary among the agents. When discontinuing the ACE inhibitor is not an ideal option, pharmacologic treatment of the cough may be considered, such as cromolyn, baclofen, theophylline, sulindac, and local anesthetics.
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