29 Questions
What is the first-line choice with therapeutic lifestyle changes for patients with underlying risk factors like kidney function and liver disease?
Biguanides
In which group of patients is metformin contraindicated due to the risk of lactic acidosis?
Patients with severe renal impairment
How should metformin be taken to minimize gastrointestinal adverse effects?
Take with food
Which factor can temporarily warrant the discontinuation of metformin due to the risk of lactic acidosis?
Receiving IV contrast material
What is a predisposing factor that would make a patient unsuitable for metformin therapy?
Active liver disease
What is the mechanism of action of sulfonylureas and non-sulfonylureas in increasing insulin secretion?
Activation of the voltage-gated Ca2+ channels
Which receptors do thiazolidinediones (TZDs) primarily act on?
PPARγ receptors
What is the main therapeutic effect of sulfonylureas and non-sulfonylureas?
Reduction in A1c levels by over 1.5%
What side effect is commonly associated with sulfonylureas?
Hypoglycemia
Which of the following is a first-generation sulfonylurea drug that is rarely used?
Nateglinide
How do sulfonylureas and non-sulfonylureas affect glucose-stimulated insulin secretion?
By depolarizing the cell membrane through KATP channel blockage
What is the mechanism of action of GLP-1 receptor agonists?
Activates GLP-1 receptors, leading to cAMP production and PKA activation
Which of the following is a therapeutic effect of GLP-1 receptor agonists?
Reduced HbA1c by more than 1.5%
What is an adverse effect commonly associated with GLP-1 receptor agonists?
Nausea/vomiting
Which GLP-1 receptor agonist is approved for the treatment of obesity?
Liraglutide
What is an important administration consideration for GLP-1 receptor agonists?
Subcutaneous administration
Which patients might benefit from GLP-1 receptor agonists in terms of cardiovascular risk according to the text?
Patients with established CV disease and T2DM
What is the main contraindication for using DPP-4 inhibitors like Sitagliptin?
Medullary thyroid cancer
Which organ is targeted for therapy in Type 2 Diabetes Mellitus?
Pancreas
What is the mechanism of action of DPP-4 inhibitors like Alogliptin?
Inhibits DPP-4 on T lymphocytes
Which of the following is a therapeutic effect of DPP-4 inhibitors like Linagliptin?
A1c reduction without hypoglycemia
What common adverse effect is associated with DPP-4 inhibitors like Saxagliptin?
Angioedema
Why are DPP-4 inhibitors like Sitagliptin considered well-tolerated in general?
Low incidence of adverse effects
Which type of cellular activity does metformin impact?
AMPK activation
Which class of medications act by selectively inhibiting the enzyme responsible for breaking down complex carbohydrates in the GI tract?
-gliptins
In patients with T2DM, which medication class is associated with a potential risk of hypoglycemia if cleared by the kidneys?
SUs/non-SUs
What is the primary metabolic effect observed with GLP-1 agonists and SGLT2 inhibitors?
Weight loss
Which type of disease is a contraindication for the use of metformin due to the risk of lactic acidosis?
Renal disease
What is a notable cancer concern associated with GLP-1 agonists in diabetic patients?
Thyroid cancer
Test your knowledge on biguanides and important considerations when prescribing them, such as the first-line choice with therapeutic lifestyle changes and contraindications in patients with predisposing factors to lactic acidosis. Understand the role of biguanides in managing patients with underlying risk factors.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
