The pharmacology of weight loss agents is a rapidly evolving field, offering new hope to patients struggling with obesity and its related comorbidities. As a pharmacist, understanding the mechanisms, side effects, and appropriate clinical use of these medications is paramount. The PharmD curriculum, through dedicated modules in courses like Patient Care 4, provides a comprehensive overview of the “Pharmacology of Weight Loss Agents/Stimulants.” This quiz will test your knowledge on the various drug classes used for weight management, from traditional stimulants to the newer GLP-1 receptor agonists, preparing you to counsel and manage patients effectively.
1. Phentermine is a sympathomimetic amine that promotes weight loss primarily by:
- a. Inhibiting lipase enzymes in the gut.
- b. Increasing the release of norepinephrine to suppress appetite.
- c. Acting as a GLP-1 receptor agonist.
- d. Blocking opioid receptors in the brain.
Answer: b. Increasing the release of norepinephrine to suppress appetite.
2. Orlistat (Xenical, Alli) works by which of the following mechanisms?
- a. It is a central nervous system stimulant.
- b. It increases metabolic rate.
- c. It inhibits gastric and pancreatic lipases, reducing the absorption of dietary fat.
- d. It modulates serotonin levels in the brain.
Answer: c. It inhibits gastric and pancreatic lipases, reducing the absorption of dietary fat.
3. Liraglutide (Saxenda) and semaglutide (Wegovy) belong to which class of medications?
- a. Lipase inhibitors
- b. Anorexiants
- c. GLP-1 Receptor Agonists
- d. Combination naltrexone/bupropion therapy
Answer: c. GLP-1 Receptor Agonists
4. A patient taking orlistat should be counseled to take which supplement, separated by at least 2 hours from the orlistat dose?
- a. Vitamin C
- b. A fat-soluble multivitamin (A, D, E, K)
- c. An iron supplement
- d. A B-complex vitamin
Answer: b. A fat-soluble multivitamin (A, D, E, K)
5. The combination product phentermine/topiramate (Qsymia) is contraindicated in patients with:
- a. Diabetes
- b. Hypertension
- c. Glaucoma
- d. Asthma
Answer: c. Glaucoma
6. The “Pharmacology of Weight Loss Agents/Stimulants” is a specific learning module in which course?
- a. PHA5784C Patient Care 4
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5784C Patient Care 4
7. GLP-1 receptor agonists promote weight loss by which mechanism?
- a. Increasing heart rate and metabolism.
- b. Increasing satiety (feeling of fullness) and slowing gastric emptying.
- c. Blocking fat absorption.
- d. Directly causing lipolysis.
Answer: b. Increasing satiety (feeling of fullness) and slowing gastric emptying.
8. A common and expected side effect of phentermine is:
- a. Drowsiness
- b. Bradycardia
- c. Increased heart rate and dry mouth
- d. Weight gain
Answer: c. Increased heart rate and dry mouth
9. Naltrexone/bupropion (Contrave) is contraindicated in patients:
- a. With hypertension.
- b. With diabetes.
- c. With an uncontrolled seizure disorder or who are taking chronic opioids.
- d. With high cholesterol.
Answer: c. With an uncontrolled seizure disorder or who are taking chronic opioids.
10. A common side effect that limits the tolerability of orlistat is:
- a. Insomnia
- b. Headache
- c. Gastrointestinal effects like flatus with oily discharge.
- d. Dry cough
Answer: c. Gastrointestinal effects like flatus with oily discharge.
11. Which weight loss medication is administered as a subcutaneous injection?
- a. Orlistat
- b. Phentermine/topiramate
- c. Liraglutide
- d. Naltrexone/bupropion
Answer: c. Liraglutide
12. The topiramate component of Qsymia is thought to contribute to weight loss through appetite suppression and altered taste perception, but it requires slow titration to minimize:
- a. Cardiovascular side effects.
- b. Gastrointestinal side effects.
- c. Cognitive side effects like memory impairment and paresthesia.
- d. Dermatological side effects.
Answer: c. Cognitive side effects like memory impairment and paresthesia.
13. A patient is prescribed naltrexone/bupropion. The pharmacist should confirm that the patient is not currently taking which class of medications for pain?
- a. NSAIDs
- b. Acetaminophen
- c. Opioids
- d. Muscle relaxants
Answer: c. Opioids
14. The primary indication for initiating pharmacotherapy for weight loss is:
- a. A desire to lose 5 pounds for cosmetic reasons.
- b. As an adjunct to diet and exercise for patients with a BMI ≥ 30 or ≥ 27 with comorbidities.
- c. As a replacement for diet and exercise.
- d. For any patient who asks for it.
Answer: b. As an adjunct to diet and exercise for patients with a BMI ≥ 30 or ≥ 27 with comorbidities.
15. GLP-1 receptor agonists carry a boxed warning for a risk of what, based on rodent studies?
- a. Myocardial infarction
- b. Stroke
- c. Thyroid C-cell tumors
- d. Severe liver injury
Answer: c. Thyroid C-cell tumors
16. The pharmacotherapy of weight loss agents is a specific lecture topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
17. How long is phentermine monotherapy approved for?
- a. Lifelong use
- b. For 2 years
- c. For short-term use (e.g., up to 12 weeks)
- d. For one week only
Answer: c. For short-term use (e.g., up to 12 weeks)
18. What is the most common side effect when initiating a GLP-1 receptor agonist?
- a. Constipation
- b. Nausea
- c. Headache
- d. Insomnia
Answer: b. Nausea
19. A patient taking orlistat eats a very high-fat meal. What is the likely consequence?
- a. The patient will have increased absorption of the fat.
- b. The patient will experience more severe gastrointestinal side effects.
- c. The orlistat will be more effective.
- d. There will be no noticeable effect.
Answer: b. The patient will experience more severe gastrointestinal side effects.
20. The “Med Chem of Weight Loss Agents/Stimulants” is a topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
21. Phentermine is classified as what schedule of controlled substance?
- a. Schedule II
- b. Schedule III
- c. Schedule IV
- d. Schedule V
Answer: c. Schedule IV
22. Which weight loss medication is available over-the-counter at a reduced strength?
- a. Phentermine
- b. Liraglutide
- c. Orlistat
- d. Bupropion
Answer: c. Orlistat
23. The bupropion component of Contrave works by:
- a. Inhibiting lipase.
- b. Acting as a GLP-1 agonist.
- c. Increasing dopamine and norepinephrine levels to reduce appetite.
- d. Blocking opioid receptors.
Answer: c. Increasing dopamine and norepinephrine levels to reduce appetite.
24. A patient taking naltrexone/bupropion should be advised to avoid taking their dose with what type of meal?
- a. A high-protein meal
- b. A high-carbohydrate meal
- c. A high-fat meal
- d. A low-sodium meal
Answer: c. A high-fat meal
25. Before dispensing phentermine/topiramate to a female of childbearing potential, the pharmacist must confirm:
- a. She has a negative pregnancy test and is on effective contraception.
- b. She has a history of diabetes.
- c. She is not taking any other medications.
- d. She can afford the medication.
Answer: a. She has a negative pregnancy test and is on effective contraception.
26. The role of the pharmacist in weight management includes:
- a. Identifying appropriate candidates for pharmacotherapy.
- b. Counseling on lifestyle modifications, side effects, and realistic expectations.
- c. Monitoring for efficacy and safety.
- d. All of the above.
Answer: d. All of the above.
27. Most “fat burner” supplements sold over-the-counter contain:
- a. A potent lipase inhibitor.
- b. A GLP-1 receptor agonist.
- c. A high dose of stimulants like caffeine.
- d. A prescription-strength anorexiant.
Answer: c. A high dose of stimulants like caffeine.
28. An active learning session covering nutrition and weight management is part of the Patient Care 4 course.
- a. True
- b. False
Answer: a. True
29. If a patient has not achieved at least a 5% weight loss after 12 weeks on the maximum tolerated dose of a weight loss agent, the medication should generally be:
- a. Continued indefinitely.
- b. Increased in dose.
- c. Discontinued.
- d. Switched to a different brand of the same drug.
Answer: c. Discontinued.
30. The “Introduction to Obesity” is a specific lecture in the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
31. The mechanism of GLP-1 agonists on weight loss involves effects on both the gut and which other organ?
- a. The liver
- b. The kidneys
- c. The brain (hypothalamus)
- d. The lungs
Answer: c. The brain (hypothalamus)
32. A patient with a history of pancreatitis should use which class of weight loss medications with caution?
- a. Lipase inhibitors
- b. Stimulants
- c. GLP-1 receptor agonists
- d. All weight loss medications are safe in pancreatitis.
Answer: c. GLP-1 receptor agonists
33. The primary benefit of using combination therapy like phentermine/topiramate is:
- a. It allows for lower doses of each component, potentially reducing side effects while achieving synergistic efficacy.
- b. It is cheaper than monotherapy.
- c. It has a faster onset of action.
- d. It can be used in all patient populations.
Answer: a. It allows for lower doses of each component, potentially reducing side effects while achieving synergistic efficacy.
34. Which of the following is NOT a mechanism of action for any FDA-approved weight loss drug?
- a. Increasing satiety.
- b. Suppressing appetite.
- c. Reducing fat absorption.
- d. Increasing the basal metabolic rate via thyroid hormone agonism.
Answer: d. Increasing the basal metabolic rate via thyroid hormone agonism.
35. A key counseling point for any weight loss medication is that it is an adjunct to, not a substitute for:
- a. Sleep
- b. Hydration
- c. Diet and exercise
- d. Vitamin supplements
Answer: c. Diet and exercise
36. Phentermine is structurally related to what other substance?
- a. Caffeine
- b. Nicotine
- c. Amphetamine
- d. Theophylline
Answer: c. Amphetamine
37. When counseling a patient on a self-injectable GLP-1 agonist, it is important to instruct them on:
- a. Rotating injection sites.
- b. Proper disposal of needles in a sharps container.
- c. How to prime the pen before first use.
- d. All of the above.
Answer: d. All of the above.
38. The naltrexone component of Contrave is an opioid antagonist. This means it will block the effects of:
- a. Ibuprofen
- b. Acetaminophen
- c. Hydrocodone
- d. Aspirin
Answer: c. Hydrocodone
39. Self-care supplements for weight loss are a topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
40. The main safety concern with many unregulated herbal weight loss products is:
- a. Their high efficacy.
- b. The presence of undeclared stimulants or prescription drugs.
- c. Their pleasant taste.
- d. Their low cost.
Answer: b. The presence of undeclared stimulants or prescription drugs.
41. How does topiramate contribute to weight loss?
- a. Its exact mechanism is unknown, but may involve appetite suppression and altered taste.
- b. It is a potent lipase inhibitor.
- c. It increases the release of norepinephrine.
- d. It blocks fat absorption.
Answer: a. Its exact mechanism is unknown, but may involve appetite suppression and altered taste.
42. A patient with uncontrolled hypertension should not be prescribed which weight loss agent?
- a. Orlistat
- b. Phentermine
- c. A GLP-1 receptor agonist
- d. All are safe.
Answer: b. Phentermine
43. A realistic expectation for weight loss with pharmacotherapy is approximately what percentage of body weight?
- a. 1-2%
- b. 5-15%
- c. 25-30%
- d. Over 40%
Answer: b. 5-15%
44. Which of the following is a cardiovascular side effect of phentermine?
- a. Bradycardia
- b. Hypotension
- c. Tachycardia
- d. Normal sinus rhythm
Answer: c. Tachycardia
45. What is the role of the pharmacist when a patient asks about an OTC weight loss supplement they saw online?
- a. To encourage the patient to buy it immediately.
- b. To provide evidence-based information on its likely efficacy and potential for harm.
- c. To state that all supplements are safe and effective.
- d. To refuse to discuss it.
Answer: b. To provide evidence-based information on its likely efficacy and potential for harm.
46. A patient reports their orlistat capsules are causing very bothersome oily spotting. The pharmacist should advise the patient to:
- a. Stop the medication immediately.
- b. Double the dose.
- c. Reduce their dietary fat intake.
- d. Take the medication on an empty stomach.
Answer: c. Reduce their dietary fat intake.
47. The primary goal of managing obesity is to:
- a. Achieve a specific number on the scale.
- b. Improve health by reducing the risk and severity of weight-related comorbidities.
- c. Fit into a smaller size of clothing.
- d. Eliminate all fat from the diet.
Answer: b. Improve health by reducing the risk and severity of weight-related comorbidities.
48. An active learning session on pharmacotherapy for weight loss is part of the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
49. Why is a REMS (Risk Evaluation and Mitigation Strategy) program required for phentermine/topiramate?
- a. Due to the high cost of the medication.
- b. Due to the risk of abuse.
- c. Due to the significant risk of teratogenicity from the topiramate component.
- d. Due to its gastrointestinal side effects.
Answer: c. Due to the significant risk of teratogenicity from the topiramate component.
50. The ultimate goal of understanding the pharmacology of weight loss agents is to:
- a. Be able to recommend them to all patients.
- b. Help appropriate patients achieve and maintain a healthier weight as part of a comprehensive lifestyle plan.
- c. Memorize a list of side effects.
- d. Pass the final exam.
Answer: b. Help appropriate patients achieve and maintain a healthier weight as part of a comprehensive lifestyle plan.