Drug Topics - November 10, 2008 - (Page 48)

Continuing Education TE ST QU E S TIO NS Write your answers on the form appearing on page 49 (photocopies of the answer form are acceptable) or on a separate sheet of paper. Mark the most appropriate answer. Questions 1-3 are related to the following patient case: SH is a 29-year-old black female who presents to your pharmacy with a prescription for sibutramine 10mg once daily. She has a history of hypertension and diabetes, no history of surgeries, and no medication allergies. Upon further review, you nd that SH is taking HCTZ 25mg PO daily, glyburide 10 mg PO BID, lisinopril 20mg PO daily, and metformin 1000 mg PO BID. She reports no use of over-the-counter medications or herbal supplements. SH is 5’4” and weighs 180 lbs (BMI 31 kg/m2). After additional questioning, SH reveals that she has been enrolled in “Taking Off the Pounds” (TOPS) weight-loss program for the last six months. She also recently gained 30 lbs after she quit smoking. SH appears android or apple-shaped. She had smoked 1 pack per day for the last 10 years. SH believes losing weight will help her “feel better about how she looks.” SH is up to date on her immunizations and has had recent blood pressure readings of: 142/96 and 152/98 this week. When asked, she reported beginning Sibutramine in the last two weeks. SH mentions that she spoke with her doctor about feeling down and depressed. Sertraline is being considered to help “her mood.” 1. How many obesity-related risk factors does SH have? a. 0 b. 1 c. 2 d. 3 2. How would you classify SH’s BMI according to the NHLBI guidelines? a. Underweight b. Healthy weight c. Overweight d. Obese 3. Which of the following medications may contribute to weight gain in SH? a. Glyburide b. Glucophage c. Hydrochlorothiazide (HCTZ) d. Lisinopril 4. Which of the following factors does not contribute to the etiology of obesity? a. Cultural in uences b. Genetic in uences c. Socioeconomic in uences d. Linguistic in uences 5. Secondary causes of obesity include all of the following except: a. Cushing syndrome b. Hypertension c. Hypothyroidism d. Insulinoma 6. Which complication associated with obesity can affect fertility and insulin resistance? a. Gout b. Metabolic syndrome c. Osteoarthritis d. Polycystic ovarian syndrome (PCOS) 7. Healthcare providers should consider recommening lifestyle modi cations to patients with a BMI of: a. 25 kg/m2 or greater b. 30 kg/m2 or greater c. 35 kg/m2 or greater d. 40 kg/m2 or greater 8. Which of the following conditions confers the highest obesity-related risk? a. Diabetes b. Endometrial cancer c. Gout d. Polycystic ovarian syndrome (PCOS) 9. What is the 6-month weight loss recommended for patients? a. 5% b. 10% c. 15% d. 20% 10. According to the Nurses’ Health Study, how much greater is the risk of experiencing symptomatic gallstones for women with a BMI of 30 or greater, compared to those with a BMI <24 kg/m2? a. No greater risk b. Twofold excess risk c. Threefold excess risk d. Fourfold excess risk 11. The risk of gallstones is increased when the rate of weight loss exceeds: a. 1.0 kg per week b. 1.5 kg per week c. 2.0 kg per week d. 2.5 kg per week Questions 12-14 are related to the following patient case: LB is a 38-year-old Caucasian female who comes into your pharmacy asking for a “magic pill” to help her lose weight. She has a history of glaucoma and sleep apnea. You have known LB for some time now and are aware of her New Year’s resolution to lose weight. After counseling LB on diet and exercise and advising her that there is no “magic pill,” you decide to recommend orlistat over the counter. 12. Which of the following is an appropriate dose of over-the-counter orlistat to recommend to LB? a. 15 mg TID b. 30 mg TID c. 60 mg TID d. 120 mg TID 13. Common adverse effects of orlistat include all of the following except: a. Flatulence with discharge b. Fecal urgency c. Increased heart rate d. Steatorrhea 14. Which of the following may be a factor related to LB’s obesity? a. Glaucoma b. Osteoarthritis c. Polycystic ovarian syndrome (PCOS) d. Obstructive sleep apnea 15. Which obesity-related medication can block the absorption of fat-soluble vitamins? a. Mazindol b. Orlistat c. Phenterimine d. Sibutramine 16. Patients who may be a candidate for bariatric surgery include those who have a BMI of at least: a. 30 kg/m2 b. 35 kg/m2 c. 40 kg/m2 d. 45 kg/m2 17. Which of the following is the surgical treatment of choice in patients with clinically severe obesity? a. Biliopancreatic bypass b. Laparoscopic adjustable gastric banding c. Roux-en-Y gastric bypass d. Vertical banded gastroplasty 18. For which of the following disease states is it inappropriate to recommend weight-loss therapy? a. Diabetes b. Hypertension c. Major depression d. Obstructive sleep apnea 19. Which of the following medications is currently approved by the FDA only for short-term use in obese patients? a. Orlistat b. Phentermine c. Rimonabant d. Sibutramine 20. Which antilipemic agent modi es the CB-1 receptor for the treatment of obesity? a. Orlistat b. Phentermine c. Rimonabant d. Sibutramine 48 DRUG TOPICS N OV. 10, 2008 W W W.D R U GTO P I C S .C O M http://WWW.DRUGTOPICS.COM

Table of Contents Feed for the Digital Edition of Drug Topics - November 10, 2008

Drug Topics - November 10, 2008 Contents Up Front Up Front in Depth Letters Rx Care Government Community Practice First Responders Clinical Practice Self-Care FDA Safety Page Weighing the Complications of Obesity New Products Viewpoint

Drug Topics - November 10, 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.