Question #1:

Inputting her weight and height into the BMI calculator, you calculate that Mrs. L has a BMI of 34.4kg/m2

Question #2:

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Answer is: Obese. 

Question #3:

Answer is: c. The FDA has seen a tremendous increase in the number of tainted herbal weight loss products in the last few years. These products may contain active, hidden ingredients such as sibutramine, the active ingredient in Meridia, a prescription weight-loss product that was removed from the market in October 2010 due to safety reasons.  

Other hidden ingredients include phenolphthalein, an ingredient in some OTC laxative products until 1999 when the FDA reclassified it as not being safe and as a potential cancer-causing agent. 

Bumetanide, another hidden ingredient found in some herbal weight loss products, is a prescription diuretic. Bumetanide carries a Boxed Warning because the drug may lead to serious and significant fluid and electrolyte loss.

Question #4:

d. Xenical and Alli have the same active ingredient, orlistat. GI events may increase when orlistat is taken with a diet high in fat (>30% total calories from fat). Some diet-related side effects include oily spotting, loose stools, and more frequent stools that may be hard to control.

Qsymia contains both phentermine and topiramate. It can cause an increase in resting heart rate although the clinical significance is unclear. Regular measurement of resting heart rate is recommended for patients taking Qsymia.

Question #5:

Answer is: e. Mrs. L should tell her psychiatrist that she is taking Belviq because the drug, when combined with other serotonergic drugs such as SSRIs, may possibly cause serotonin syndrome or neuroleptic malignant syndrome-like reactions.

Drugs that target the CNS have been associated with depression or suicidal ideation. It is important to monitor for the emergence of worsening of depression, as well as suicidal thoughts or behavior.

Belviq is contraindicated during pregnancy.  It is classified as Category X.

Question #6:

Response to therapy should be evaluated by week 12. If a patient has not lost at least 5% of baseline body weight, Belviq should be discontinued. It is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.