The pharmacotherapy of weight loss is a crucial component of a comprehensive obesity management plan, serving as an important adjunct to lifestyle modifications. As a pharmacist, your role extends far beyond dispensing these medications; it involves careful patient assessment, extensive counseling, and diligent monitoring to ensure safe and effective treatment. The PharmD curriculum, through dedicated modules in courses like Patient Care 4, provides the in-depth knowledge required to manage these complex therapeutic agents. This quiz will test your understanding of the clinical use, side effect management, and counseling points for the key pharmacotherapies used in weight management.
1. According to clinical guidelines, pharmacotherapy for weight management is indicated as an adjunct to lifestyle modifications for a patient with a BMI ≥ 27 kg/m² and what else?
- a. A desire to lose weight for cosmetic reasons.
- b. At least one weight-related comorbidity.
- c. A family history of obesity.
- d. No history of previous diet attempts.
Answer: b. At least one weight-related comorbidity.
2. What is the primary therapeutic goal for weight loss pharmacotherapy?
- a. To achieve a BMI of <25 kg/m² within 3 months.
- b. To achieve and maintain a weight loss of at least 5-10% of initial body weight.
- c. To replace the need for diet and exercise.
- d. To be used for short-term, rapid weight loss only.
Answer: b. To achieve and maintain a weight loss of at least 5-10% of initial body weight.
3. If a patient has not achieved at least a 5% weight loss after 12 weeks on the maximum tolerated dose of a medication, what is the generally recommended action?
- a. Double the dose.
- b. Continue the medication for at least one year.
- c. Add a second weight loss agent.
- d. Discontinue the medication due to lack of efficacy.
Answer: d. Discontinue the medication due to lack of efficacy.
4. A patient taking orlistat should be counseled to take the medication:
- a. On an empty stomach.
- b. Once a week.
- c. With a fat-containing meal.
- d. At bedtime.
Answer: c. With a fat-containing meal.
5. Liraglutide (Saxenda) and semaglutide (Wegovy) are GLP-1 receptor agonists administered via which route?
- a. Oral tablet
- b. Transdermal patch
- c. Subcutaneous injection
- d. Intravenous infusion
Answer: c. Subcutaneous injection
6. The “Pharmacotherapy of Weight loss Agents” 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. Naltrexone/bupropion (Contrave) is contraindicated in a patient currently taking which of the following?
- a. Metformin
- b. Lisinopril
- c. Chronic opioid therapy
- d. Atorvastatin
Answer: c. Chronic opioid therapy
8. A common and dose-limiting side effect of the topiramate component in Qsymia is:
- a. Weight gain
- b. Paresthesia and cognitive effects (e.g., “brain fog”).
- c. Diarrhea
- d. Hypertension
Answer: b. Paresthesia and cognitive effects (e.g., “brain fog”).
9. What is a key counseling point for a patient starting a GLP-1 receptor agonist like liraglutide?
- a. The most common side effect is insomnia.
- b. Nausea is a very common side effect, especially during dose titration.
- c. The medication should be taken with a high-fat meal.
- d. The injection should be administered in the bicep muscle.
Answer: b. Nausea is a very common side effect, especially during dose titration.
10. Phentermine monotherapy is only approved for:
- a. Lifelong use.
- b. Short-term use (≤12 weeks).
- c. Use in pediatric patients.
- d. Use in patients with uncontrolled hypertension.
Answer: b. Short-term use (≤12 weeks).
11. The pharmacology of weight loss agents is a specific lecture topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
12. A patient taking orlistat should be advised to supplement which vitamins, separated from the orlistat dose?
- a. B-complex vitamins
- b. Vitamin C and Zinc
- c. Fat-soluble vitamins (A, D, E, K)
- d. Folic acid
Answer: c. Fat-soluble vitamins (A, D, E, K)
13. The REMS program for phentermine/topiramate is in place due to the significant risk of:
- a. Cardiovascular events.
- b. Hepatotoxicity.
- c. Teratogenicity (fetal harm).
- d. Abuse and dependence.
Answer: c. Teratogenicity (fetal harm).
14. A patient taking naltrexone/bupropion should be advised to avoid taking the dose with a high-fat meal because it can:
- a. Decrease the absorption of the drug.
- b. Increase the systemic exposure of bupropion and the risk of seizures.
- c. Cause a severe hypertensive crisis.
- d. Inactivate the naltrexone component.
Answer: b. Increase the systemic exposure of bupropion and the risk of seizures.
15. A patient with a history of medullary thyroid carcinoma should not be prescribed which class of weight loss agents?
- a. Lipase inhibitors
- b. GLP-1 receptor agonists
- c. Sympathomimetic amines
- d. Combination naltrexone/bupropion
Answer: b. GLP-1 receptor agonists
16. The introduction to obesity pharmacotherapy is covered in the Patient Care 4 course.
- a. True
- b. False
Answer: a. True
17. Which of the following is a common cardiovascular side effect of phentermine?
- a. Bradycardia
- b. Hypotension
- c. Tachycardia and increased blood pressure
- d. Atrial fibrillation
Answer: c. Tachycardia and increased blood pressure
18. How should a pharmacist counsel a patient on managing the nausea associated with GLP-1 receptor agonists?
- a. Discontinue the medication immediately.
- b. Advise them to eat smaller, more frequent meals and avoid high-fat foods.
- c. Take an over-the-counter antiemetic before every injection.
- d. Double the dose to overcome the nausea.
Answer: b. Advise them to eat smaller, more frequent meals and avoid high-fat foods.
19. A patient is considered to have a successful response to weight loss pharmacotherapy if they achieve at least what percentage of weight loss at 3 months?
- a. 1%
- b. 2%
- c. 5%
- d. 10%
Answer: c. 5%
20. The curriculum includes a transcending concept on obesity and bariatric dosing.
- a. True
- b. False
Answer: a. True
21. A patient who has had a Roux-en-Y gastric bypass should ideally receive which formulation of a medication?
- a. An extended-release tablet
- b. An enteric-coated tablet
- c. An immediate-release, crushed tablet or a liquid formulation
- d. A large, hard-pressed tablet
Answer: c. An immediate-release, crushed tablet or a liquid formulation
22. Which weight loss medication is a C-IV controlled substance?
- a. Orlistat
- b. Liraglutide
- c. Naltrexone/bupropion
- d. Phentermine
Answer: d. Phentermine
23. The bupropion component of Contrave is contraindicated in patients with a history of:
- a. Asthma
- b. Seizure disorders or eating disorders like bulimia/anorexia.
- c. GERD
- d. Migraines
Answer: b. Seizure disorders or eating disorders like bulimia/anorexia.
24. The primary role of the pharmacist in weight management pharmacotherapy is to:
- a. Ensure safe and effective medication use through assessment, counseling, and monitoring.
- b. Guarantee weight loss for every patient.
- c. Act as a personal trainer.
- d. Provide diet plans.
Answer: a. Ensure safe and effective medication use through assessment, counseling, and monitoring.
25. Which of the following is NOT an FDA-approved indication for liraglutide 3 mg (Saxenda)?
- a. Chronic weight management
- b. Type 2 diabetes management
- c. Use in conjunction with a reduced-calorie diet
- d. Use in conjunction with increased physical activity
Answer: b. Type 2 diabetes management
26. The most common side effect associated with orlistat is related to which organ system?
- a. Cardiovascular
- b. Central Nervous System
- c. Gastrointestinal
- d. Renal
Answer: c. Gastrointestinal
27. Before dispensing phentermine, a pharmacist should screen for which of the following conditions?
- a. Uncontrolled hypertension
- b. A history of cardiovascular disease
- c. Hyperthyroidism
- d. All of the above
Answer: d. All of the above
28. An active learning session on nutrition and weight management is part of the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
29. A patient starting naltrexone/bupropion who also uses opioid pain medication for chronic back pain will likely experience:
- a. Enhanced pain relief.
- b. Opioid withdrawal symptoms, as naltrexone will block the opioid receptors.
- c. No change in their pain control.
- d. A hypertensive crisis.
Answer: b. Opioid withdrawal symptoms, as naltrexone will block the opioid receptors.
30. The “Pharmacology of Weight Loss Agents” lecture is part of which course module?
- a. Module 5: Nutrition & Weight Management
- b. Module 1: PUD and GERD
- c. Module 4: Gastrointestinal Infections
- d. Module 6: Colorectal Cancer
Answer: a. Module 5: Nutrition & Weight Management
31. How are GLP-1 receptor agonists for weight loss typically titrated?
- a. The dose is started high and tapered down.
- b. The dose is started low and gradually increased over weeks to months to improve tolerability.
- c. The dose is adjusted based on the patient’s daily weight.
- d. The dose remains the same throughout therapy.
Answer: b. The dose is started low and gradually increased over weeks to months to improve tolerability.
32. What is a key counseling point for a patient starting phentermine/topiramate?
- a. Take it at bedtime to help with sleep.
- b. This medication can be stopped abruptly without any issues.
- c. Take it in the morning to avoid insomnia; do not stop abruptly due to the topiramate component.
- d. Crush the extended-release capsule for faster effect.
Answer: c. Take it in the morning to avoid insomnia; do not stop abruptly due to the topiramate component.
33. The most effective long-term treatments for obesity are:
- a. Over-the-counter herbal supplements.
- b. Pharmacotherapy alone.
- c. A comprehensive lifestyle program, with pharmacotherapy or bariatric surgery as potential adjuncts.
- d. Diet alone.
Answer: c. A comprehensive lifestyle program, with pharmacotherapy or bariatric surgery as potential adjuncts.
34. The primary purpose of combining topiramate with phentermine is to:
- a. Allow for long-term use and provide a synergistic or complementary mechanism of action.
- b. Counteract the side effects of phentermine.
- c. Make the phentermine more potent.
- d. Improve the taste.
Answer: a. Allow for long-term use and provide a synergistic or complementary mechanism of action.
35. A patient should be counseled that GI side effects from orlistat can be minimized by:
- a. Taking the medication on an empty stomach.
- b. Adhering to a low-fat diet.
- c. Taking a higher dose of the medication.
- d. Combining it with a stimulant laxative.
Answer: b. Adhering to a low-fat diet.
36. A patient taking liraglutide for weight loss should be monitored for signs of which condition, although rare?
- a. Pancreatitis
- b. Gout
- c. Angioedema
- d. Anemia
Answer: a. Pancreatitis
37. Which weight loss agent is available in both a low-strength OTC version and a higher-strength prescription version?
- a. Liraglutide
- b. Phentermine
- c. Orlistat
- d. Bupropion
Answer: c. Orlistat
38. The self-care aspect of weight loss supplements is a topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
39. Before recommending any weight loss agent, the pharmacist should first assess the patient’s:
- a. Motivation and readiness to engage in lifestyle changes.
- b. Favorite foods.
- c. Social media preferences.
- d. Ability to pay for the most expensive drug.
Answer: a. Motivation and readiness to engage in lifestyle changes.
40. The pharmacotherapy of weight loss is a lecture topic within the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
41. Which of these agents is NOT FDA-approved for chronic weight management?
- a. Semaglutide (Wegovy)
- b. Phentermine/topiramate (Qsymia)
- c. Metformin
- d. Naltrexone/bupropion (Contrave)
Answer: c. Metformin
42. A patient taking naltrexone/bupropion should have their ____ monitored, especially upon initiation.
- a. Blood glucose
- b. Blood pressure and heart rate
- c. Serum potassium
- d. INR
Answer: b. Blood pressure and heart rate
43. The primary reason for the titration schedule of naltrexone/bupropion is to:
- a. Save the patient money.
- b. Improve tolerability and reduce the risk of side effects like nausea.
- c. Allow the pharmacy to order more stock.
- d. Ensure the drug is taken with food.
Answer: b. Improve tolerability and reduce the risk of side effects like nausea.
44. Which of the following is a realistic weekly weight loss goal?
- a. 5-10 pounds
- b. 0.5-2 pounds
- c. 10-15 pounds
- d. 0.1 pounds
Answer: b. 0.5-2 pounds
45. Pharmacotherapy is generally considered successful if it helps a patient achieve and maintain a weight loss of at least:
- a. 1%
- b. 2%
- c. 3%
- d. 5%
Answer: d. 5%
46. Which of the following is an absolute contraindication to using phentermine?
- a. Mild, controlled hypertension.
- b. A history of cardiovascular disease (e.g., MI, stroke).
- c. Type 2 diabetes.
- d. A BMI of 31 kg/m².
Answer: b. A history of cardiovascular disease (e.g., MI, stroke).
47. A patient wants to use an OTC supplement with green tea extract for weight loss. The pharmacist should counsel that the active ingredient providing a modest effect is:
- a. L-theanine
- b. Catechins
- c. Caffeine
- d. Vitamin C
Answer: c. Caffeine
48. An active learning session on obesity and weight management is part of the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
49. The overall strategy for using pharmacotherapy in weight management is:
- a. To use it as a crutch so the patient does not have to change their habits.
- b. To “kick-start” weight loss and help the patient adhere to lifestyle changes over the long term.
- c. To use it for a maximum of one month in all cases.
- d. To replace bariatric surgery.
Answer: b. To “kick-start” weight loss and help the patient adhere to lifestyle changes over the long term.
50. The ultimate goal of obesity pharmacotherapy is to:
- a. Help a patient achieve a specific aesthetic look.
- b. Improve health outcomes by reducing the burden of weight-related comorbidities.
- c. Sell the newest medication.
- d. Ensure the patient loses more than 20% of their body weight.
Answer: b. Improve health outcomes by reducing the burden of weight-related comorbidities.