NR 566 Midterm Exam Study Guide
Advanced Pharmacology for Care of the
Family - Chamberlain College|A+
Confirmed Already Passed!!
Which non-amphetamines are FDA approved for weight loss that have lower abuse
risk? - ANSWER-Phentermine and Diethylpropion
How does Phentermine and Diethylpropion promote weight loss? - ANSWER--Promote
weight loss by decreasing appetite
-They are central nervous system (CNS) stimulants that suppress appetite by increasing
the availability of norepinephrine at receptors in the brain
What is the maximum recommended duration of use for non-amphetamines? -
ANSWER-3 months or less
What drug schedule are Phentermine and Diethylpropion under? - ANSWER-Schedule
IV
What labs should be monitored with Phentermine and Diethylpropion? What condition
should we screen for? - ANSWER--baseline CMP (watch electrolytes and creatinine)
-screen for depression
Phentermine adverse effects - ANSWER--increase HR and BP
-dry mouth and constipation
What is role of topiramate in weight loss? - ANSWER-Increases satiety
What are some Phentermine/topiramate contraindications for use? - ANSWER-not
approved in children and contraindicated with severe hepatic impairment
How should we educate patient to take Phentermine/topiramate to avoid insomnia? -
ANSWER-given before 1600
What are some high-risk patient conditions that we should use Phentermine/topiramate
with caution? - ANSWER-hx drug abuse, glaucoma, pregnant, HTN, hyperthyroidism
Phentermine/topiramate adverse effects - ANSWER-insomnia, nervousness, anxiety,
depression, blurred vision
,Which of the following would be a contraindication to prescribing
phentermine/topiramate? Select all that apply. - ANSWER-A) Glaucoma
B) Hypothyroidism
C) Hypertension
D) Hyperthyroidism
E) Vitamin D Deficiency
F) A, B, E
ANSWER: A,C,D
Orlistat is a lipase inhibitor that acts on the _________ and reduces absorption of fat by
30%. - ANSWER-GI tract
Take multivitamin ___hours before/after to supplement fat-soluble vitamins that may not
be absorbed well when taking Orlistat. - ANSWER-2
Orlistat is OTC as 60 mg TID with meals. Not approved in children <____. - ANSWER-
12
Orlistat results in the least amount of weight loss of all. How much? - ANSWER-2-3%
body weight (7 lbs in year)
Orlistat adverse effects - ANSWER-Fecal incontinence, oily rectal leakage, flatus,
abdominal cramps. liver damage (light-colored stools, dark urine, fatigue, jaundice,
anorexia)
When is Orlistat contraindicated? - ANSWER-In those with malabsorption syndrome or
cholestasis
What vitamin deficiency are we concerned about when taking Orlistat...especially if the
patient is on coumadin? - ANSWER-Monitor Coumadin as Vitamin K deficiency may
occur and intensify effect of Coumadin.
A patient with a BMI of 27 would be considered: - ANSWER-overweight
Lorcaserin adverse effects - ANSWER-headache, URI, back pain, hypoglycemia (in
DM), blood dyscrasias, cognitive impairment, psychiatric disorders, priapism, pulmonary
hypertension, and valvular heart disease
Lorcaserin MOA - ANSWER-Reduces waist circumference, fasting glucose, insulin, total
cholesterol, LDL, triglycerides
When is Lorcaserin contraindicated? - ANSWER-CrCl <30
-Not approved in children
,Lorcaserin drug interactions - ANSWER--MAOI inhibitors, SSRIs, SNRIs, St. Johns
wart, and triptans
-Increased risk for serotonin syndrome
Naltrexone and Bupropion black box warning - ANSWER-increased risk for suicidal
ideation and suicide attempts in children, adolescents, and young adults
Do not take Naltrexone and Bupropion within ___weeks of taking a _____. - ANSWER--
two
-MAOI
Due to Naltrexone and Bupropion antagonist effects, it can reduce effects of what? -
ANSWER-opioids
Naltrexone and Bupropion contraindications - ANSWER-HTN, seizure disorders, eating
disorders, alcohol or drug withdrawal
Liraglutide MOA - ANSWER--promotes weight loss by slowing gastric emptying
-increases satiety
-Not approved children.
When taking Liraglutide, it is not unusual for baseline HR to increase ______bpm -
ANSWER-10-20
-monitor for tachycardia
When taking Liraglutide, monitor for ________ in patients with diabetes - ANSWER-
hypoglycemia
Baseline labs for Liraglutide - ANSWER-lipids, CMP, HgA1C q 6 months, triglycerides
Liraglutide black box warning - ANSWER-associated with a risk for thyroid C-cell tumors
based on studies in rodents
-Contraindicated in people with multiple endocrine neoplasia syndrome type 2 (MEN 2)
or personal/family history of medullary thyroid carcinoma
Those trying to LOSE weight should exercise at least ____ min/week or more -
ANSWER-150
What BMI is bariatric surgery considered? - ANSWER-35 or more
Common procedures:
-Gastric Bypass Surgery (Roux-en-Y procedure)
-Laparoscopic implantation of an adjustable gastric band
What is typical weight loss for those who diligently adhere to medication and lifestyle
therapy?____% whereas >____% is exceptional - ANSWER-10-15%
, > 15%
Most weight loss occurs during the first ___ months of treatment - ANSWER-6
T or F: Dosage adjustments are not indicated for orlistat, diethylpropion, and
phentermine in the elderly - ANSWER-T
Stage 0: - ANSWER-BMI ≥ 25 = lifestyle therapy -> consider drug therapy if lifestyle
therapy is ineffective to meet goals
Stage 1: - ANSWER-BMI of 25-26 = lifestyle therapy -> consider drug therapy if lifestyle
therapy is ineffective to meet goals
BMI ≥ 27 = lifestyle therapy, consider drug therapy
Stage 2: - ANSWER-BMI 25-26 = lifestyle therapy -> consider drug therapy if ineffective
to meet goals
BMI 27-34 = lifestyle therapy, drug therapy
BMI ≥ 35 = lifestyle therapy + drug therapy + consider bariatric surgery
Inhibitors (decrease medication metabolism) - ANSWER-Valproate
Isoniazid
Sulfonamide
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit juice
Quinidine
"VISA credit card debt inhibits spending on designers like CK to look GQ"
Cimetidine
Ciprofloxacin
Erythromycin
INH
Inducers (increase medication metabolism) - ANSWER-Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
"CRAP GPS"
Advanced Pharmacology for Care of the
Family - Chamberlain College|A+
Confirmed Already Passed!!
Which non-amphetamines are FDA approved for weight loss that have lower abuse
risk? - ANSWER-Phentermine and Diethylpropion
How does Phentermine and Diethylpropion promote weight loss? - ANSWER--Promote
weight loss by decreasing appetite
-They are central nervous system (CNS) stimulants that suppress appetite by increasing
the availability of norepinephrine at receptors in the brain
What is the maximum recommended duration of use for non-amphetamines? -
ANSWER-3 months or less
What drug schedule are Phentermine and Diethylpropion under? - ANSWER-Schedule
IV
What labs should be monitored with Phentermine and Diethylpropion? What condition
should we screen for? - ANSWER--baseline CMP (watch electrolytes and creatinine)
-screen for depression
Phentermine adverse effects - ANSWER--increase HR and BP
-dry mouth and constipation
What is role of topiramate in weight loss? - ANSWER-Increases satiety
What are some Phentermine/topiramate contraindications for use? - ANSWER-not
approved in children and contraindicated with severe hepatic impairment
How should we educate patient to take Phentermine/topiramate to avoid insomnia? -
ANSWER-given before 1600
What are some high-risk patient conditions that we should use Phentermine/topiramate
with caution? - ANSWER-hx drug abuse, glaucoma, pregnant, HTN, hyperthyroidism
Phentermine/topiramate adverse effects - ANSWER-insomnia, nervousness, anxiety,
depression, blurred vision
,Which of the following would be a contraindication to prescribing
phentermine/topiramate? Select all that apply. - ANSWER-A) Glaucoma
B) Hypothyroidism
C) Hypertension
D) Hyperthyroidism
E) Vitamin D Deficiency
F) A, B, E
ANSWER: A,C,D
Orlistat is a lipase inhibitor that acts on the _________ and reduces absorption of fat by
30%. - ANSWER-GI tract
Take multivitamin ___hours before/after to supplement fat-soluble vitamins that may not
be absorbed well when taking Orlistat. - ANSWER-2
Orlistat is OTC as 60 mg TID with meals. Not approved in children <____. - ANSWER-
12
Orlistat results in the least amount of weight loss of all. How much? - ANSWER-2-3%
body weight (7 lbs in year)
Orlistat adverse effects - ANSWER-Fecal incontinence, oily rectal leakage, flatus,
abdominal cramps. liver damage (light-colored stools, dark urine, fatigue, jaundice,
anorexia)
When is Orlistat contraindicated? - ANSWER-In those with malabsorption syndrome or
cholestasis
What vitamin deficiency are we concerned about when taking Orlistat...especially if the
patient is on coumadin? - ANSWER-Monitor Coumadin as Vitamin K deficiency may
occur and intensify effect of Coumadin.
A patient with a BMI of 27 would be considered: - ANSWER-overweight
Lorcaserin adverse effects - ANSWER-headache, URI, back pain, hypoglycemia (in
DM), blood dyscrasias, cognitive impairment, psychiatric disorders, priapism, pulmonary
hypertension, and valvular heart disease
Lorcaserin MOA - ANSWER-Reduces waist circumference, fasting glucose, insulin, total
cholesterol, LDL, triglycerides
When is Lorcaserin contraindicated? - ANSWER-CrCl <30
-Not approved in children
,Lorcaserin drug interactions - ANSWER--MAOI inhibitors, SSRIs, SNRIs, St. Johns
wart, and triptans
-Increased risk for serotonin syndrome
Naltrexone and Bupropion black box warning - ANSWER-increased risk for suicidal
ideation and suicide attempts in children, adolescents, and young adults
Do not take Naltrexone and Bupropion within ___weeks of taking a _____. - ANSWER--
two
-MAOI
Due to Naltrexone and Bupropion antagonist effects, it can reduce effects of what? -
ANSWER-opioids
Naltrexone and Bupropion contraindications - ANSWER-HTN, seizure disorders, eating
disorders, alcohol or drug withdrawal
Liraglutide MOA - ANSWER--promotes weight loss by slowing gastric emptying
-increases satiety
-Not approved children.
When taking Liraglutide, it is not unusual for baseline HR to increase ______bpm -
ANSWER-10-20
-monitor for tachycardia
When taking Liraglutide, monitor for ________ in patients with diabetes - ANSWER-
hypoglycemia
Baseline labs for Liraglutide - ANSWER-lipids, CMP, HgA1C q 6 months, triglycerides
Liraglutide black box warning - ANSWER-associated with a risk for thyroid C-cell tumors
based on studies in rodents
-Contraindicated in people with multiple endocrine neoplasia syndrome type 2 (MEN 2)
or personal/family history of medullary thyroid carcinoma
Those trying to LOSE weight should exercise at least ____ min/week or more -
ANSWER-150
What BMI is bariatric surgery considered? - ANSWER-35 or more
Common procedures:
-Gastric Bypass Surgery (Roux-en-Y procedure)
-Laparoscopic implantation of an adjustable gastric band
What is typical weight loss for those who diligently adhere to medication and lifestyle
therapy?____% whereas >____% is exceptional - ANSWER-10-15%
, > 15%
Most weight loss occurs during the first ___ months of treatment - ANSWER-6
T or F: Dosage adjustments are not indicated for orlistat, diethylpropion, and
phentermine in the elderly - ANSWER-T
Stage 0: - ANSWER-BMI ≥ 25 = lifestyle therapy -> consider drug therapy if lifestyle
therapy is ineffective to meet goals
Stage 1: - ANSWER-BMI of 25-26 = lifestyle therapy -> consider drug therapy if lifestyle
therapy is ineffective to meet goals
BMI ≥ 27 = lifestyle therapy, consider drug therapy
Stage 2: - ANSWER-BMI 25-26 = lifestyle therapy -> consider drug therapy if ineffective
to meet goals
BMI 27-34 = lifestyle therapy, drug therapy
BMI ≥ 35 = lifestyle therapy + drug therapy + consider bariatric surgery
Inhibitors (decrease medication metabolism) - ANSWER-Valproate
Isoniazid
Sulfonamide
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit juice
Quinidine
"VISA credit card debt inhibits spending on designers like CK to look GQ"
Cimetidine
Ciprofloxacin
Erythromycin
INH
Inducers (increase medication metabolism) - ANSWER-Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
"CRAP GPS"
