Dr. Sarah Molasky
speaker
127 appearances
1 recordings
1 series
first heard Mar 2024
last heard Mar 2024
Dr. Sarah Molasky’s voice in public audio — every appearance, attributed to the second.
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Yeah, so I have been in pharmacy since I believe 2011, 2012 as a technician and eventually became a pharmacist. I tried out different types of pharmacy, but my passion was community pharmacy. which is not generally what pharmacy schools want you to go into. They want you to go into hospital or research or more clinical care, which is more prestigious.
But I really love working with people directly and building relationships with people. And I've been a pharmacist on Northside for almost five years. In July, it'll be five years that I'll have been a pharmacist in Northside. So really happy serving the community I serve and I wouldn't do anything else.
Yeah, so historically speaking, weight loss drugs have been around for decades, right? And possibly longer if we go back into really old school pharmacy where you had tinctures and all of that. But in terms of government recognized weight loss medications, they started out as stimulants. And so stimulants can include things like caffeine.
Because caffeine and other stimulants have a side effect of appetite suppression. So this was based on the idea that weight gain was solely due to overconsumption of calories. Is that medically accurate? Not necessarily. Everybody has very different bodies. And so the cause for weight gain can be varied. It can be medical. It can be a medication that's causing it.
interaction with another medication, certain types of foods. So it's really dependent on each person, but the original types of weight loss medications were stimulants. So they would make people feel very energetic. They might move around more. It would raise their heart rate and blood pressure, but also it might make them feel like eating less food.
And that's kind of been the main sorts of therapies we've had. There's a lot of over-the-counter weight loss medications that use the same exact concept, including ones that are still around today. I never recommend them to my patients because I think they're trash.
They have a lot of side effects that are really problematic, especially for patients who already have risks for heart disease or where high blood pressure can cause a lot more health issues for them. So then came in the Other therapies like bupropion, topiramate, fentramine, these are ones that, again, are meant to suppress craving or suppress appetite.
So then we have diabetic injectables, which are called GLP-1s or glucagon-like peptide 1 receptor agonists. It's just a fancy way of saying it gloms onto a certain receptor in our body that tells our body to make more insulin to bring down our blood sugar. And it also can get that same receptor in our brain, but it tells it, hey, we're actually full. We don't have to eat more.
So it has a dual action to make us potentially lose weight. This was not developed as a weight loss drug. The first JLP1 that was approved in America was Biada, which was a two-time-a-day injectable. It's still used today, but less often just because adherence isn't great, right? Not many people want to inject themselves twice a day if they have the option of once a day.
So then in comes Victoza, which was a once a day dosing drug. And that seemed to show more efficacy for certain types of important health issues that many diabetics face. And that includes, you know, heart health and potentially kidney health. And then you got once a week ones as well. And the big one that we hear about is Ozempic, right?
That's the trendy one that you've been hearing about with Hollywood stars injecting Ozempic to lose their seven extra pounds or whatever. And that has really been a trip in retail pharmacy because my patients who are diabetic need that medication. And there were months where I could not get that medication in the correct dose to my patients.
There is first a period of time where the fancy special needle they used for that one, because Ozempic uses a different needle than the typical diabetes pens do, they couldn't get that needle in. So the medication was in stock, but they couldn't get the medication out to patients because they didn't have enough of the needle because of shortages.
So I already got to see that shortage impact my diabetic patients. But then we got Hollywood stars starting to talk about how they're using Ozempic to lose weight. And I do have friends who live in the L.A. area who said everyone's talking about Ozempic. This is whether they're in health care or not, they're talking about it. So it really has become a trend.
And I think part of it is social media, which is a double edged sword. Right. People can become aware of really important things like some people may find out, oh, you know, that health problem I've been having that sounds exactly what this like what this person is describing. I'm going to talk to my doctor about it. That's great.
But when it comes to, oh, this person has lost weight using this drug, I want to lose weight using this drug. That's where we get a really big problem. And Ozempic technically is not meant to be used for weight loss. It is meant to be used for diabetes.
But of course, when the drug manufacturer realized there was a larger weight loss component than many other medications in that same class, they applied for a patent to have it approved for weight loss specifically and created a separate product called Wagovi, which is literally the same thing, but in a slightly different dose. Eventually.
Three of the doses are actually the same between Ozempic and Wegovy. And so those have really taken flight. But Wegovy is on constant shortage. And in case anyone's wondering, no, my pharmacy does not have it in stock. Please don't call. We literally field 10 plus calls a day just of people asking if we have certain types of Wegovy in stock. We don't. This is a nationwide shortage.
And then there's one other injectable that came out more recently that people were really excited about both for the weight loss aspect, but also for the glucose control aspect. And that was Terzepatide or Munjaro. And Mujaro is a dual action medication. It is a GLP-1, just like Ozempic or Victoza or Biada, but it also contains GIP, which has like seven different technical names.
But essentially what it does is when the blood sugar is getting too low, it taps on the liver and says, hey, can you just produce a little bit more sugar just so we can stay balanced? And so it's cool because it responds to what's actually going on in the body and tries to prevent really, really low blood sugar, which in diabetics can be very dangerous. It's called hypoglycemia.
And if your blood sugar gets too low and your liver is not being responsive and pumping out more sugar, you can pass out or have other health issues. So manjaro is really interesting, but also has much higher weight loss than sugar. you know, Ozempic did. And so that's now like the, the star when it comes to weight loss meds.
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