NUR 635 MIDTERM CONCEPT REVIEW GUIDE
2026 CLINICAL DECISION MAKING IN
MEDICATION MANAGEMENT
◉ 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
2026 CLINICAL DECISION MAKING IN
MEDICATION MANAGEMENT
◉ 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
