Anti-Obesity Agents

Question 1

which artificial sweetener is 300-fold sweeter than sucrose and caused bladder cancer in rats due to micro-crystals which do not develop in humans?

Answer 1

Saccharin

Question 2

which artificial sweetener is 30-50 fold sweeter than sucrose and was banned by the FDA due to concerns over bladder cancer?

Answer 2

Cyclamate

Question 3

which artificial sweetener is 200-fold sweeter than sucrose and is a methylated dipeptide?

Answer 3

Aspartame

Question 4

which artificial sweetener has a phenylalanine metabolite that can harm pts with phenylketouria?

Answer 4

Aspartame

Question 5

which which artificial sweetener is 7,000-13,000 fold sweeter than sucrose and is not used in foods and has negligible effect on PKU pts?

Answer 5

Neotame

Question 6

which artificial sweetener is 200-fold sweeter than sucrose, is not metabolized, is used in beverages, and is combined with other sweeteners due to bitter aftertaste?

Answer 6

Acesulfame-K

Question 7

which artificial sweetener is 600-fold sweeter than sucrose and is a chlorinated derivative of sucrose?

Answer 7

Sucralose (splenda)

Question 8

which artificial sweetener is 200-fold sweeter than sucrose and has two different formulations depending on the number of methyl groups attached to glucose on the structure?

Answer 8

Stevia

Question 9

which artificial sweetener is the same sweetness as glucose, but 40% fewer calories and is a polyol structure?

Answer 9

Xylitol

Question 10

what drug is labeled as a fatty acid substitution that has a structure of sucrose esterified with stearic acid?

Answer 10

Olestra

Question 11

which drug can cause hypovitaminosis and why?

Answer 11

Olestra because fat soluble vitamins need fat to be properly absorbed

Question 12

What drug is an irreversible inhibitor of pancreatic lipase?

Answer 12

Orlistat

Question 13

what anti-obesity drug has interactions with cyclosporine, levothyroxine, warfarin, and fat soluble vitamins?

Answer 13

Orlistat

Question 14

what are the 2 brand names for Orlistat?
why does it not have systemic SEs?
what SEs does it have?
what is the dosing?

Answer 14

Alli and Xenical
it is not absorbed
GI-related: oily stools, cramps and flatulence
Alli: 60mg tid with fat-containing meals
Xenical: 120mg tid with fat-containing meals

Question 15

Anorexiants are only used for people with a BMI over?
Length of therapy should be?

Answer 15

30
less than 12 weeks, and not to exceed 6 months

Question 16

Which drug is a schedule IV that with continued use can lead to tolerance and rebound weight gain?

Answer 16

Phentermine

Question 17

What drug is phentermine combined with?

Answer 17

Topiramate

Question 18

what drug was withdrawn from the market due to concerns over heart valve disease?

Answer 18

Fenfluramine

Question 19

what is the MoA of Sibutramine?
why was it withdrawn?

Answer 19

inhibit NT reuptake and stimulation of thermogenesis by activating B3 in adipose tissue
concerns of CVD

Question 20

why was Lorcaserin removed from the market?

Answer 20

increased risk of cancer

Question 21

what is the name of the first CB1 receptor blocker?
why was it removed from market?

Answer 21

Rimonabant
concerns of increased risk of suicide

Question 22

what are the functions of GLP-1 receptor agonists?

Answer 22

increase insulin secretion
inhibit gastric acid secretion and emptying
increase satiety by acting on CNS

Question 23

Liraglutide:
how was it formulated to be long-acting?

Answer 23

The lysine attached to liraglutide had palmitic acid attached to it using a Glutamine in between

Question 24

which GLP-1 is not yet approved for obesity?

Answer 24

Exenatide

Question 25

what is the brand name of Semaglutide that is approved for obesity? How is it dosed and why?

Answer 25

Wegovy once weekly due it it's longer half-life

Question 26

which drug had a BBW for increased risk of toe and foot amputations that was removed in 2020?

Answer 26

Canagliflozin

Question 27

what is Xigduo XR?

Answer 27

a combo product of dapagliflozin and metformin

Question 28

what is the MoA of 2,4-Dinitrophenol?

Answer 28

causes energy from B-oxidation to be converted to heat instead of ATP... NEVER APPROVED

Question 29

what is Dr. Stevens proposed drug that induces thermogenesis?

Answer 29

Xanthohumol Pyrazole Derivative

Question 30

pts with uncontrolled HPT or history of heart disease should not use which two meds?

Answer 30

phentermine and diethylpropion

Question 31

pts w/ T2DM who are overweight should be prescribed what drug classes for weight loss in addition to metformin?

Answer 31

GLP-1 and SGLT-2 inhibitors

Question 32

women overweight with comorbidities who need contraception should use what kind?

Answer 32

oral

Question 33

what drug class should be avoided in pts with chronic inflammatory diseases due to causing weight gain?

Answer 33

corticosteroids

Question 34

what are drug-induced causes of obesity?

Answer 34

TCAs oral contraceptives antipsychs anticonvulsants glucocorticoids sulfonylureas glitazones B blockers

Question 35

what defect of the thyroid can cause weight gain?

Answer 35

hypothyroidism

Question 36

if a med shows weight loss of less than ____ after 3 months, it should be discontinued

Answer 36

5%

Question 37

ziprasidone causes ____ weight gain compared to olanzapine

Answer 37

less

Question 38

which anti-epileptic drugs are associated with weight loss?

Answer 38

felbamate topiramate zonisamide

Question 39

which anti-epileptic drugs are associated with weight gain?

Answer 39

gabapentin pregabalin valproic acid vigabatrin carbamazepine

Question 40

which anti-epileptic drugs are weight-neutral?

Answer 40

lamotrigine levetiracetam phenytoin

Question 41

valproic acid has shown to cause weight _____

Answer 41

gain

Question 42

which drug is the most commonly prescribed drug for weight loss and is often used off label?

Answer 42

Phentermine

Question 43

When is long term prescribing of phentermine considered reasonable?

Answer 43

-no evidence of CVD -no psych disease or substance abuse -pt aware that phentermine long term use is off label -no significant increase in pulse or BP -significant weight loss occurs