Biguanides and Important Considerations Quiz
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Questions and Answers

What is the first-line choice with therapeutic lifestyle changes for patients with underlying risk factors like kidney function and liver disease?

  • Biguanides (correct)
  • Sulfonylureas
  • Thiazolidinediones
  • Incretin mimetics

In which group of patients is metformin contraindicated due to the risk of lactic acidosis?

  • Patients with well-controlled diabetes
  • Patients with no underlying health conditions
  • Patients with severe renal impairment (correct)
  • Patients with mild liver disease

How should metformin be taken to minimize gastrointestinal adverse effects?

  • Take with food (correct)
  • Take on an empty stomach
  • Titrate quickly
  • Start with a high dose

Which factor can temporarily warrant the discontinuation of metformin due to the risk of lactic acidosis?

<p>Receiving IV contrast material (B)</p> Signup and view all the answers

What is a predisposing factor that would make a patient unsuitable for metformin therapy?

<p>Active liver disease (A)</p> Signup and view all the answers

What is the mechanism of action of sulfonylureas and non-sulfonylureas in increasing insulin secretion?

<p>Activation of the voltage-gated Ca2+ channels (A)</p> Signup and view all the answers

Which receptors do thiazolidinediones (TZDs) primarily act on?

<p>PPARγ receptors (D)</p> Signup and view all the answers

What is the main therapeutic effect of sulfonylureas and non-sulfonylureas?

<p>Reduction in A1c levels by over 1.5% (D)</p> Signup and view all the answers

What side effect is commonly associated with sulfonylureas?

<p>Hypoglycemia (A)</p> Signup and view all the answers

Which of the following is a first-generation sulfonylurea drug that is rarely used?

<p>Nateglinide (C)</p> Signup and view all the answers

How do sulfonylureas and non-sulfonylureas affect glucose-stimulated insulin secretion?

<p>By depolarizing the cell membrane through KATP channel blockage (A)</p> Signup and view all the answers

What is the mechanism of action of GLP-1 receptor agonists?

<p>Activates GLP-1 receptors, leading to cAMP production and PKA activation (B)</p> Signup and view all the answers

Which of the following is a therapeutic effect of GLP-1 receptor agonists?

<p>Reduced HbA1c by more than 1.5% (D)</p> Signup and view all the answers

What is an adverse effect commonly associated with GLP-1 receptor agonists?

<p>Nausea/vomiting (B)</p> Signup and view all the answers

Which GLP-1 receptor agonist is approved for the treatment of obesity?

<p>Liraglutide (C)</p> Signup and view all the answers

What is an important administration consideration for GLP-1 receptor agonists?

<p>Subcutaneous administration (B)</p> Signup and view all the answers

Which patients might benefit from GLP-1 receptor agonists in terms of cardiovascular risk according to the text?

<p>Patients with established CV disease and T2DM (A)</p> Signup and view all the answers

What is the main contraindication for using DPP-4 inhibitors like Sitagliptin?

<p>Medullary thyroid cancer (C)</p> Signup and view all the answers

Which organ is targeted for therapy in Type 2 Diabetes Mellitus?

<p>Pancreas (C)</p> Signup and view all the answers

What is the mechanism of action of DPP-4 inhibitors like Alogliptin?

<p>Inhibits DPP-4 on T lymphocytes (D)</p> Signup and view all the answers

Which of the following is a therapeutic effect of DPP-4 inhibitors like Linagliptin?

<p>A1c reduction without hypoglycemia (C)</p> Signup and view all the answers

What common adverse effect is associated with DPP-4 inhibitors like Saxagliptin?

<p>Angioedema (A)</p> Signup and view all the answers

Why are DPP-4 inhibitors like Sitagliptin considered well-tolerated in general?

<p>Low incidence of adverse effects (B)</p> Signup and view all the answers

Which type of cellular activity does metformin impact?

<p>AMPK activation (A)</p> Signup and view all the answers

Which class of medications act by selectively inhibiting the enzyme responsible for breaking down complex carbohydrates in the GI tract?

<p>-gliptins (D)</p> Signup and view all the answers

In patients with T2DM, which medication class is associated with a potential risk of hypoglycemia if cleared by the kidneys?

<p>SUs/non-SUs (D)</p> Signup and view all the answers

What is the primary metabolic effect observed with GLP-1 agonists and SGLT2 inhibitors?

<p>Weight loss (A)</p> Signup and view all the answers

Which type of disease is a contraindication for the use of metformin due to the risk of lactic acidosis?

<p>Renal disease (A)</p> Signup and view all the answers

What is a notable cancer concern associated with GLP-1 agonists in diabetic patients?

<p>Thyroid cancer (D)</p> Signup and view all the answers

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