Lipase Inhibitors

Every question here, with the answer

1. A client starting orlistat asks how to take it. Which instruction is correct?

   1. Take it with your fat-soluble vitamins at the same time.
   2. Take it up to 1 hour before meals that contain fat.
   3. Take it only once a week.
   4. Take it at bedtime on an empty stomach.

   Answer: Take it up to 1 hour before meals that contain fat.

   Orlistat capsules are taken up to three times a day, up to 1 hour before meals containing fat. Vitamin supplements are taken 2 hours before or after it, not at the same time.

2. A client on orlistat reports oily stools and fecal urgency after two weeks. What is the nurse's best response?

   1. Stop the drug immediately; this is an allergic reaction.
   2. Double the dose to speed up weight loss.
   3. These are signs of hypothyroidism.
   4. These are common GI effects that often subside within 4 weeks; avoid very high-fat meals.

   Answer: These are common GI effects that often subside within 4 weeks; avoid very high-fat meals.

   Because orlistat is not absorbed, the common side effects are GI, including oily stool and fecal urgency, and they often subside within 4 weeks. Avoiding very high-fat meals minimizes them; the other options are not supported.

3. A client takes levothyroxine and has just been prescribed orlistat. What should the nurse teach?

   1. Take orlistat 30 minutes after levothyroxine.
   2. Stop levothyroxine while taking orlistat.
   3. Take both together in the morning.
   4. Take orlistat 4 hours before or 4 hours after levothyroxine.

   Answer: Take orlistat 4 hours before or 4 hours after levothyroxine.

   Orlistat is separated from levothyroxine by 4 hours to avoid reducing the serum availability of levothyroxine. Taking them together or only 30 minutes apart does not meet that gap.

4. Which teaching points should the nurse include for a client taking orlistat? Select all that apply.

   1. Take a multivitamin that contains vitamins A, D, E, and K.
   2. Skip the multivitamin because orlistat improves vitamin absorption.
   3. Eat very high-fat meals to make the drug work better.
   4. Spread daily fat intake evenly across three meals.
   5. Take the vitamin 2 hours before or after orlistat.

   Answer: Take a multivitamin that contains vitamins A, D, E, and K., Spread daily fat intake evenly across three meals., Take the vitamin 2 hours before or after orlistat.

   Orlistat can prevent absorption of fat-soluble vitamins, so a multivitamin with A, D, E and K is taken 2 hours apart, and fat is spread evenly over meals. Very high-fat meals worsen GI effects.

5. The nurse is reviewing the history of a client asking about orlistat. Which conditions are contraindications? Select all that apply.

   1. Gallbladder disease
   2. Pregnancy
   3. Controlled seasonal allergies
   4. Cholestasis
   5. Hypothyroidism

   Answer: Gallbladder disease, Pregnancy, Cholestasis, Hypothyroidism

   Orlistat is contraindicated in gallbladder disease, cholestasis, hypothyroidism and pregnancy, among others. Seasonal allergies are not listed.

6. A client with type 2 diabetes has lost weight on orlistat and reports shakiness and sweating. What should the nurse suspect?

   1. Normal hunger before meals
   2. Hypoglycemia; the diabetes medication may need to be reduced.
   3. An allergic reaction to orlistat
   4. Vitamin K deficiency

   Answer: Hypoglycemia; the diabetes medication may need to be reduced.

   With weight loss, a client's need for diabetes medication may fall, so clients with diabetes are monitored closely for hypoglycemia and report low glucose. The other options do not explain these symptoms.