ENDO

Question 1

Lipase inhibitor

Answer 1

Orlistat

Question 2

Drugs for obesity are considered effective if theydemonstrate at least a ___ greater reduction in body weight as compared to placebo (no treatment).

Answer 2

5%

Question 3

Anorexiants (Appetite Supressant) drugs

Answer 3

• Phentermine

- Diethylpropion

Question 4

• Increases the release of norepinephrine and dopamine from the nerve terminals and inhibits reuptake of these neurotransmitters, thereby increasing levels of neurotransmitters in the brain.
• The increase in norepinephrine signals a “fight-or-flight” response by the body, which, in turn, decreases appetite.

Answer 4

Phentermine

Question 5

All of the anorexiants are classified as CONTROLLED SUBSTANCES due to_____

Answer 5

potential for dependence or abuse.

Question 6

Adverse effect of Diethylpropion

Answer 6

• COMMON: dry mouth, headache, insomnia, and constipation

* Increased heart rate and blood pressure

Question 7

Avoidance of Diethylpropion/Phentermine in patients with

Answer 7

• history of uncontrolled hypertension,
• cardiovascular disease,
• arrhythmias,
• heart failure, or
• stroke.

Question 8

Concomitant use of anorexiants with _________ should be avoided.

Answer 8

• monoamine oxidase inhibitors (MAOIs) or other

- sympathomimetics should be avoided.

Question 9

It is indicated for weight loss orweight maintenance and its clinical utility is limited by gastrointestinal adverse effects.

Answer 9

Orlistat

Question 10

Inhibits gastric and pancreatic lipases, thus decreasing the breakdown of dietary fat into smaller molecules that can be absorbed.

Answer 10

Orlistat

Question 11

• Most common: gastrointestinal symptoms, such as oily spotting, flatulence with discharge, fecal urgency, and increased defecation
• These effects may be minimized through a low-fat diet and the use of concomitant cholestyramine.
• Contraindicated in pregnancy and in patients with chronic malabsorption syndrome or cholestasis

Answer 11

Orlistat

Question 12

• Interferes with the absorption of fat-soluble vitamins and β-carotene
• Advise to take a multivitamin supplement that contains vitamins A, D, E, and K and also β-carotene

Answer 12

Orlistat

Question 13

• A newer serotonin agonist, with selectivity for the 2C serotonin receptor (5-HT2C)
• Used for chronic weight management
• Not used as it causes valvular heart disease

Answer 13

Lorcaserin

Question 14

Mode of Action: Lorcaserin

• Selectively activates _____
• Stimulates _______ which activate melanocortin receptors
• Decrease in ____
• Discontinue if the px does not lose at least 5% of body weight after____of use

Answer 14

• 5-HT2C receptors
• pro-opiomelanocortin neurons
• appetite
• 12 weeks

Question 15

The development of life-threatening ______ has been reported with the use of serotonin agonists.

Answer 15

serotonin syndrome or neuroleptic malignant syndrome

Question 16

Avoid concomitant use with

• selective serotonin reuptake inhibitors,
• serotonin–norepinephrine reuptake inhibitors,
• MAOIs,
• or other serotonergic drugs

Answer 16

Lorcaserin

Question 17

The combination of phentermine and ___ has been approved for long-term use in the treatment of obesity.

Answer 17

topiramate

Question 18

Should not be stopped abruptly as SEIZURES may be precipitated

Answer 18

phentermine/topiramate

Question 19

Adverse Effects of Topiramate

Answer 19

• Cleft palate
• Paresthesias
• Suicidal ideation
• Cognitive dysfunction

Question 20

A treatment option for patients with a BMI of 40 kg/m2 or greater who instituted but failed an adequate exercise and diet program (with/without adjunctive drug therapy) and who present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, & obstructive sleep apnea

Answer 20

Bariatric Surgery

Question 21

The 2 major elements of bone, are crucial not only for the mechanical strength of the skeleton but also for the normal function of many other cells in the body.

Answer 21

Calcium and phosphorus

Question 22

Are primary regulators of calcium and phosphorus

Answer 22

Parathyroid hormone (PTH) and vitamin D

Question 23

Play secondary roles of regulators of calcium and phosphorus

Answer 23

calcitonin, glucocorticoids, and estrogens

Question 24

Nonhormonal regulators of bone mineral homestasis

Answer 24

• Biphosphonates
• Fluride
• Calcimimetics

Question 25

A condition of PTH excess characterized by hypercalcemia, bone pain, cognitive abnormalities, and renal stones.

Answer 25

Hyperparathyroidism

Question 26

Primary Hyperparathyroidism results from

Answer 26

parathyroid gland dysfunction

Question 27

Secondary Hyperparathyroidism results from

Answer 27

Chronic kidney disease

Question 28

A condition of abnormal mineralization of adult bone secondary to nutritional deficiency of vitamin D or inherited defects in the formation or action of active vitamin D metabolites.

Answer 28

Osteomalacia

Question 29

Abnormal loss of bone with increased risk of fractures, spinal deformities, and loss of stature; remaining bone is histologically normal.

Answer 29

Osteoporosis

Question 30

A bone disorder, of unknown origin, characterized by excessive bone destruction and disorganized repair. Complications include skeletal deformity, musculoskeletal pain, kidney stones, and organ dysfunction secondary to pressure from bony overgrowth

Answer 30

Paget’s disease

Question 31

The same as osteomalacia, but it occurs in the growing skeleton

Answer 31

Rickets

Question 32

An osteoblast-derived growth factor that stimulates osteoclast activity and osteoclast precursor differentiation

Answer 32

RANK ligand

Question 33

At the continuous high concentrations seen in hyperparathyroidism, the net effect of elevated PTH is

Answer 33

- increased bone resorption, - hypercalcemia, and - hyperphosphatemia.

Question 34

Recombinant truncated form of PTH, for parenteral treatment of osteoporosis.

Answer 34

teriparatide

Question 35

In the treatment of secondary hyperparathyroidism associated with chronic kidney disease, ____ reduces PTH levels, corrects hypocalcemia, and improves bone disease It can also result in hypercalcemia and hypercalciuria through direct effects on intestinal, bone, and renal handling of calcium and phosphate.

Answer 35

calcitriol

Question 36

Are approved for treatment of secondary hyperparathyroidism in patients with chronic kidney disease.

Answer 36

- doxercalciferol | - paricalcitol

Question 37

Is approved for topical treatment of psoriasis.

Answer 37

Calcipotriene (calcipotriol)

Question 38

The primary toxicity caused by chronic overdose with vitamin D or its active metabolites is

Answer 38

- hypercalcemia, - hyperphosphatemia, and - hypercalciuria.

Question 39

The hormone has been used in conditions in which an acute reduction of serum calcium is needed like in Paget’s disease and hypercalcemia.

Answer 39

Calcitonin

Question 40

Is approved for treatment of osteoporosis and has been shown to increase bone mass and to reduce spine fractures.

Answer 40

Calcitonin

Question 41

Can prevent or delay bone loss in postmenopausal women. Their action involves the inhibition of PTH-stimulated bone resorption

Answer 41

Estrogens and selective estrogen receptor modulators (SERMs; eg, raloxifene)

Question 42

Inhibit bone mineral maintenance. As a result, chronic systemic use of these drugs is a common cause of osteoporosis in adults. However, these hormones are useful in the intermediate-term treatment of hypercalcemia.

Answer 42

glucocorticoids

Question 43

Short-chain organic polyphosphate compounds that reduce both the resorption and the formation of bone by an action on the basic hydroxyapatite crystal structure.

Answer 43

Biphosphonates

Question 44

Are used to manage the hypercalcemia associated with some malignancies and to treat Paget’s disease. It is used commonly to prevent and treat all forms of osteoporosis.

Answer 44

Biphosphonates

Question 45

Treatment of hypercalcemia associated with Paget’s disease and malignancies.

Answer 45

Pamidronate, zoledronic acid, or etidronate

Question 46

The primary toxicity of the low oral bisphosphonate doses used for osteoporosis is

Answer 46

gastric and esophageal irritation

Question 47

A human monoclonal antibody that binds to and prevents the action of RANKL. It inhibits osteoclast formation and activity and can be used for treatment of postmenopausal osteoporosis.

Answer 47

Denosumab

Question 48

- lowers PTH by activating the calcium-sensing receptor in the parathyroid gland. - It is used for oral treatment of secondary hyperparathyroidism in chronic kidney disease & for the treatment of hypercalcemia in patients with parathyroid carcinoma. - Its toxicities include hypocalcemia and adynamic bone disease, a condition of profoundly decreased bone cell activity.

Answer 48

Cinacalcet

Question 49

An organic ion bound to 2 atoms of strontium, promotes osteoclast apoptosis and increases concentrations of bone formation markers; it is used in Europe for treatment of osteoporosis.

Answer 49

Strontium ranelate

Question 50

- Is effective in managing the hypercalcemia associated with some malignancies and possibly Paget’s disease. - It acts by inhibiting bone resorption. - To prevent nephrotoxicity, patients need to be well hydrated and to have good renal output.

Answer 50

Gallium nitrate

Question 51

Used to reduce serum calcium and bone resorption in Paget’s disease and hypercalcemia.

Answer 51

plicamycin (mithramycin)