NR 566 Advanced Pharmacology for Care of Family Midterm
Exam Review: (Latest 2026/2027 Update) Weight Loss
Agents, Antibiotics, Antivirals, Antifungals, Antihelmintics,
HIV Therapies | Q&A | Grade A | 100% Correct Verified
Answers
Subject: Advanced Pharmacology – Weight Loss Agents (Phentermine, Diethylpropion, Topiramate,
Orlistat, Lorcaserin, Naltrexone/Bupropion, Liraglutide); Antibiotics (Penicillins, Cephalosporins,
Tetracyclines, Macrolides, Aminoglycosides, Sulfonamides, Trimethoprim, Fluoroquinolones,
Vancomycin, Clindamycin, Linezolid, Metronidazole); Antifungals (Azoles, Terbinafine, Griseofulvin);
Antivirals (Acyclovir, Ganciclovir, Oseltamivir, Palivizumab); HIV Antiretrovirals (NRTIs, NNRTIs, PIs,
INSTIs, CCR5 antagonists, Fusion inhibitors); PREP/PEP; Hepatitis B/C treatments; Antihelmintics
(Mebendazole, Albendazole, Ivermectin, Praziquantel); CYP450 inhibitors/inducers; Bactericidal vs
Bacteriostatic; Pregnancy Categories; Antibiotic Stewardship; MRSA; C. difficile; UTI; CAP; Otitis
Media; Tinea Infections; Influenza; RSV.
Source: NR 566 Midterm Blueprint 2026/2027, FDA, CDC, IDSA, AHA, WHO.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
Which non-amphetamines are FDA approved for weight loss that have lower abuse risk?
Correct Answer: Phentermine and Diethylpropion
1. Phentermine and diethylpropion are schedule IV controlled substances (lower abuse potential than
amphetamines). They are CNS stimulants that suppress appetite by increasing norepinephrine
availability in the brain.
2. Maximum recommended duration: 3 months or less (due to tolerance and abuse potential). Adverse
effects: increased HR/BP, dry mouth, constipation.
3. Baseline labs: CMP (watch electrolytes, creatinine). Screen for depression. Contraindications: hx drug
abuse, glaucoma, HTN, hyperthyroidism, pregnancy, severe hepatic impairment.
Phentermine/topiramate – education to avoid insomnia
Correct Answer: given before 1600 (4 PM) to avoid insomnia.
1. Topiramate (extended-release) in combination with phentermine causes CNS stimulation. Dosing in
morning or early afternoon prevents sleep disruption.
2. Adverse effects: insomnia, nervousness, anxiety, depression, blurred vision. Contraindications:
glaucoma, hyperthyroidism, HTN, MAOIs, pregnancy.
, Which would be a contraindication to prescribing phentermine/topiramate? (Select all that
apply)
Correct Answer: A) Glaucoma, C) Hypertension, D) Hyperthyroidism
1. Phentermine/topiramate contraindications: glaucoma (topiramate can acutely worsen narrow-angle
glaucoma), uncontrolled hypertension (phentermine increases BP), hyperthyroidism (CNS stimulant
worsens symptoms).
2. Hypothyroidism not a contraindication; vitamin D deficiency not related.
Orlistat – mechanism and administration
Correct Answer: Orlistat is a lipase inhibitor that acts on the GI tract and reduces absorption of fat
by 30%. OTC as 60 mg TID with meals. Not approved in children <12 years.
1. Take multivitamin 2 hours before or after orlistat (to supplement fat-soluble vitamins A, D, E, K).
Weight loss: 2-3% body weight (about 7 lbs/year).
2. Adverse effects: fecal incontinence, oily rectal leakage, flatus, abdominal cramps, liver damage (light-
colored stools, dark urine, fatigue, jaundice, anorexia). Contraindicated in malabsorption syndrome or
cholestasis.
3. Monitor Coumadin (warfarin) – vitamin K deficiency may occur and intensify anticoagulant effect.
Lorcaserin – adverse effects and contraindications
Correct Answer: Adverse effects: headache, URI, back pain, hypoglycemia (in DM), blood
dyscrasias, cognitive impairment, psychiatric disorders, priapism, pulmonary hypertension, valvular
heart disease. Contraindications: CrCl <30, not approved in children.
1. Lorcaserin MOA: serotonin 2C receptor agonist – reduces waist circumference, fasting glucose,
insulin, total cholesterol, LDL, triglycerides.
2. Drug interactions: MAOIs, SSRIs, SNRIs, St. John's wort, triptans (increased risk for serotonin
syndrome).
Naltrexone and Bupropion – black box warning and contraindications
Correct Answer: Black box warning: increased risk for suicidal ideation and suicide attempts in
children, adolescents, and young adults. Do not take within 2 weeks of a MAOI. Contraindications:
HTN, seizure disorders, eating disorders, alcohol or drug withdrawal.
1. Naltrexone (opioid antagonist) + bupropion (atypical antidepressant) reduces appetite. Due to
antagonist effects, can reduce effects of opioids (precipitate withdrawal).
2. Not for use with opioids or during opioid withdrawal.
Liraglutide – MOA and monitoring
Correct Answer: Liraglutide (GLP-1 receptor agonist) promotes weight loss by slowing gastric
emptying and increasing satiety. Not approved for children. Baseline HR may increase 10-20 bpm
(monitor for tachycardia). Monitor for hypoglycemia in patients with diabetes.
1. Baseline labs: lipids, CMP, HbA1c q6 months, triglycerides. Black box warning: associated with thyroid
C-cell tumors; contraindicated in MEN-2 or personal/family history of medullary thyroid carcinoma.
2. Weight loss: typical 10-15% with diligent adherence; >15% exceptional. Most weight loss occurs
during first 6 months.
Exam Review: (Latest 2026/2027 Update) Weight Loss
Agents, Antibiotics, Antivirals, Antifungals, Antihelmintics,
HIV Therapies | Q&A | Grade A | 100% Correct Verified
Answers
Subject: Advanced Pharmacology – Weight Loss Agents (Phentermine, Diethylpropion, Topiramate,
Orlistat, Lorcaserin, Naltrexone/Bupropion, Liraglutide); Antibiotics (Penicillins, Cephalosporins,
Tetracyclines, Macrolides, Aminoglycosides, Sulfonamides, Trimethoprim, Fluoroquinolones,
Vancomycin, Clindamycin, Linezolid, Metronidazole); Antifungals (Azoles, Terbinafine, Griseofulvin);
Antivirals (Acyclovir, Ganciclovir, Oseltamivir, Palivizumab); HIV Antiretrovirals (NRTIs, NNRTIs, PIs,
INSTIs, CCR5 antagonists, Fusion inhibitors); PREP/PEP; Hepatitis B/C treatments; Antihelmintics
(Mebendazole, Albendazole, Ivermectin, Praziquantel); CYP450 inhibitors/inducers; Bactericidal vs
Bacteriostatic; Pregnancy Categories; Antibiotic Stewardship; MRSA; C. difficile; UTI; CAP; Otitis
Media; Tinea Infections; Influenza; RSV.
Source: NR 566 Midterm Blueprint 2026/2027, FDA, CDC, IDSA, AHA, WHO.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
Which non-amphetamines are FDA approved for weight loss that have lower abuse risk?
Correct Answer: Phentermine and Diethylpropion
1. Phentermine and diethylpropion are schedule IV controlled substances (lower abuse potential than
amphetamines). They are CNS stimulants that suppress appetite by increasing norepinephrine
availability in the brain.
2. Maximum recommended duration: 3 months or less (due to tolerance and abuse potential). Adverse
effects: increased HR/BP, dry mouth, constipation.
3. Baseline labs: CMP (watch electrolytes, creatinine). Screen for depression. Contraindications: hx drug
abuse, glaucoma, HTN, hyperthyroidism, pregnancy, severe hepatic impairment.
Phentermine/topiramate – education to avoid insomnia
Correct Answer: given before 1600 (4 PM) to avoid insomnia.
1. Topiramate (extended-release) in combination with phentermine causes CNS stimulation. Dosing in
morning or early afternoon prevents sleep disruption.
2. Adverse effects: insomnia, nervousness, anxiety, depression, blurred vision. Contraindications:
glaucoma, hyperthyroidism, HTN, MAOIs, pregnancy.
, Which would be a contraindication to prescribing phentermine/topiramate? (Select all that
apply)
Correct Answer: A) Glaucoma, C) Hypertension, D) Hyperthyroidism
1. Phentermine/topiramate contraindications: glaucoma (topiramate can acutely worsen narrow-angle
glaucoma), uncontrolled hypertension (phentermine increases BP), hyperthyroidism (CNS stimulant
worsens symptoms).
2. Hypothyroidism not a contraindication; vitamin D deficiency not related.
Orlistat – mechanism and administration
Correct Answer: Orlistat is a lipase inhibitor that acts on the GI tract and reduces absorption of fat
by 30%. OTC as 60 mg TID with meals. Not approved in children <12 years.
1. Take multivitamin 2 hours before or after orlistat (to supplement fat-soluble vitamins A, D, E, K).
Weight loss: 2-3% body weight (about 7 lbs/year).
2. Adverse effects: fecal incontinence, oily rectal leakage, flatus, abdominal cramps, liver damage (light-
colored stools, dark urine, fatigue, jaundice, anorexia). Contraindicated in malabsorption syndrome or
cholestasis.
3. Monitor Coumadin (warfarin) – vitamin K deficiency may occur and intensify anticoagulant effect.
Lorcaserin – adverse effects and contraindications
Correct Answer: Adverse effects: headache, URI, back pain, hypoglycemia (in DM), blood
dyscrasias, cognitive impairment, psychiatric disorders, priapism, pulmonary hypertension, valvular
heart disease. Contraindications: CrCl <30, not approved in children.
1. Lorcaserin MOA: serotonin 2C receptor agonist – reduces waist circumference, fasting glucose,
insulin, total cholesterol, LDL, triglycerides.
2. Drug interactions: MAOIs, SSRIs, SNRIs, St. John's wort, triptans (increased risk for serotonin
syndrome).
Naltrexone and Bupropion – black box warning and contraindications
Correct Answer: Black box warning: increased risk for suicidal ideation and suicide attempts in
children, adolescents, and young adults. Do not take within 2 weeks of a MAOI. Contraindications:
HTN, seizure disorders, eating disorders, alcohol or drug withdrawal.
1. Naltrexone (opioid antagonist) + bupropion (atypical antidepressant) reduces appetite. Due to
antagonist effects, can reduce effects of opioids (precipitate withdrawal).
2. Not for use with opioids or during opioid withdrawal.
Liraglutide – MOA and monitoring
Correct Answer: Liraglutide (GLP-1 receptor agonist) promotes weight loss by slowing gastric
emptying and increasing satiety. Not approved for children. Baseline HR may increase 10-20 bpm
(monitor for tachycardia). Monitor for hypoglycemia in patients with diabetes.
1. Baseline labs: lipids, CMP, HbA1c q6 months, triglycerides. Black box warning: associated with thyroid
C-cell tumors; contraindicated in MEN-2 or personal/family history of medullary thyroid carcinoma.
2. Weight loss: typical 10-15% with diligent adherence; >15% exceptional. Most weight loss occurs
during first 6 months.
