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</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</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</p> Signup and view all the answers

    Which receptors do thiazolidinediones (TZDs) primarily act on?

    <p>PPARγ receptors</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%</p> Signup and view all the answers

    What side effect is commonly associated with sulfonylureas?

    <p>Hypoglycemia</p> Signup and view all the answers

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

    <p>Nateglinide</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</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</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%</p> Signup and view all the answers

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

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

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

    <p>Liraglutide</p> Signup and view all the answers

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

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

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

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

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

    <p>Pancreas</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</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</p> Signup and view all the answers

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

    <p>Angioedema</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</p> Signup and view all the answers

    Which type of cellular activity does metformin impact?

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

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

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

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

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

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