Oral Agents for Diabetes Part 6.docx

**Slide 41: Alpha-Glucosidase Inhibitors (AGIs)** 1. **What is the primary mechanism of action of alpha-glucosidase inhibitors like acarbose and miglitol?** - A. Increase insulin secretion - B. Delay the breakdown and absorption of complex carbohydrates - C. Increase gluco...

**Slide 41: Alpha-Glucosidase Inhibitors (AGIs)** 1. **What is the primary mechanism of action of alpha-glucosidase inhibitors like acarbose and miglitol?** - A. Increase insulin secretion - B. Delay the breakdown and absorption of complex carbohydrates - C. Increase glucose reabsorption in the kidneys - D. Increase hepatic glucose production\ **Answer:** B. Delay the breakdown and absorption of complex carbohydrates​(Oral Agents for Diabete...) 2. **Which of the following is a common adverse effect of alpha-glucosidase inhibitors?** - A. Hypoglycemia - B. Flatulence and abdominal discomfort - C. Hypertension - D. Weight gain\ **Answer:** B. Flatulence and abdominal discomfort​(Oral Agents for Diabete...) 3. **Alpha-glucosidase inhibitors should be taken:** - A. With the first bite of a meal - B. 30 minutes before meals - C. On an empty stomach - D. At bedtime\ **Answer:** A. With the first bite of a meal​(Oral Agents for Diabete...) **Slide 42: Monitoring with Alpha-Glucosidase Inhibitors** 1. **Which of the following lab values should be monitored in patients on alpha-glucosidase inhibitors?** - A. Liver function tests (LFTs) - B. Complete blood count (CBC) - C. Serum calcium - D. Prothrombin time (PT)\ **Answer:** A. Liver function tests (LFTs)​(Oral Agents for Diabete...) 2. **For patients on alpha-glucosidase inhibitors, monitoring of post-meal blood glucose (SMBG) may be necessary in which patient population?** - A. Patients with mild renal impairment - B. Patients with inflammatory bowel disease - C. Select patients with high postprandial glucose levels - D. Patients on sulfonylureas\ **Answer:** C. Select patients with high postprandial glucose levels​(Oral Agents for Diabete...) 3. **Alpha-glucosidase inhibitors are contraindicated in patients with which of the following conditions?** - A. Chronic kidney disease - B. Short bowel syndrome - C. Type 1 diabetes - D. Gestational diabetes\ **Answer:** B. Short bowel syndrome​(Oral Agents for Diabete...) **Slide 43: DPP-4 Inhibitors - Mechanism of Action** 1. **DPP-4 inhibitors primarily affect which of the following hormones?** - A. Insulin and glucagon - B. Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) - C. Amylin and somatostatin - D. Ghrelin and insulin\ **Answer:** B. Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)​(Oral Agents for Diabete...) 2. **How do DPP-4 inhibitors help regulate blood glucose levels in Type 2 diabetes?** - A. Stimulate insulin secretion only during fasting - B. Increase insulin synthesis and decrease glucagon secretion in response to elevated glucose - C. Inhibit glucose reabsorption in the kidneys - D. Stimulate pancreatic beta-cell proliferation\ **Answer:** B. Increase insulin synthesis and decrease glucagon secretion in response to elevated glucose​(Oral Agents for Diabete...) 3. **Which of the following is a major action of GLP-1, a hormone affected by DPP-4 inhibitors?** - A. Increase gastric motility - B. Stimulate hepatic glucose production - C. Reduce postprandial glucose levels - D. Inhibit insulin release\ **Answer:** C. Reduce postprandial glucose levels​(Oral Agents for Diabete...) **Slide 44: DPP-4 Inhibitors - Adverse Effects** 1. **Which of the following is a known adverse effect of DPP-4 inhibitors?** - A. Severe joint pain - B. Hypotension - C. Constipation - D. Weight gain\ **Answer:** A. Severe joint pain​(Oral Agents for Diabete...) 2. **DPP-4 inhibitors are associated with an increased risk of which of the following conditions?** - A. Hypothyroidism - B. Acute pancreatitis - C. Chronic kidney disease - D. Liver failure\ **Answer:** B. Acute pancreatitis​(Oral Agents for Diabete...) 3. **Which of the following is NOT a common side effect of DPP-4 inhibitors?** - A. Hypoglycemia - B. Rash - C. Severe gastrointestinal disturbances - D. Urinary tract infections\ **Answer:** C. Severe gastrointestinal disturbances​(Oral Agents for Diabete...) **Slide 45: Clinical Pearls for DPP-4 Inhibitors** 1. **DPP-4 inhibitors typically decrease HbA1c by approximately:** - A. 0.2-0.5% - B. 0.5-0.7% - C. 1-1.5% - D. 2-3%\ **Answer:** B. 0.5-0.7%​(Oral Agents for Diabete...) 2. **Which of the following is true about DPP-4 inhibitors when used in combination with other diabetes medications?** - A. They are contraindicated with sulfonylureas - B. They are weight neutral and can be combined with metformin - C. They cause significant weight gain when combined with insulin - D. They must be used cautiously with GLP-1 agonists\ **Answer:** B. They are weight neutral and can be combined with metformin​(Oral Agents for Diabete...) 3. **Which DPP-4 inhibitor does not require dose adjustment in patients with renal impairment?** - A. Alogliptin - B. Linagliptin - C. Saxagliptin - D. Sitagliptin\ **Answer:** B. Linagliptin​(Oral Agents for Diabete...) \#\#\# \*\*Slide 46: DPP-4 Inhibitors - Mechanism of Action\*\* 1\. \*\*Which of the following hormones does DPP-4 inhibitors prevent from being inactivated, thereby enhancing its action?\*\* \- A. Glucagon-like peptide 1 (GLP-1) \- B. Insulin-like growth factor \- C. Amylin \- D. Somatostatin \*\*Answer:\*\* A. Glucagon-like peptide 1 (GLP-1) 2\. \*\*What is the primary effect of DPP-4 inhibitors on glucagon levels in patients with Type 2 Diabetes?\*\* \- A. Increases glucagon secretion \- B. Reduces glucagon secretion \- C. No effect on glucagon secretion \- D. Inhibits glucagon release during fasting \*\*Answer:\*\* B. Reduces glucagon secretion 3\. \*\*Which of the following is a unique feature of DPP-4 inhibitors in terms of preserving glucose response during hypoglycemia?\*\* \- A. They stimulate insulin secretion regardless of blood glucose levels \- B. They inhibit the glucagon response during fasting \- C. They preserve the glucagon response during hypoglycemia \- D. They block glucagon release completely \*\*Answer:\*\* C. They preserve the glucagon response during hypoglycemia \-\-- \#\#\# \*\*Slide 47: DPP-4 Inhibitors - Adverse Effects and Clinical Pearls\*\* 1\. \*\*Which of the following adverse effects is associated with DPP-4 inhibitors?\*\* \- A. Severe joint pain \- B. Weight gain \- C. Hypotension \- D. Dyslipidemia \*\*Answer:\*\* A. Severe joint pain 2\. \*\*What is the recommended action if a patient taking DPP-4 inhibitors presents with signs of pancreatitis?\*\* \- A. Decrease the dose \- B. Continue therapy but monitor closely \- C. Discontinue the medication immediately \- D. Increase fluid intake to manage symptoms \*\*Answer:\*\* C. Discontinue the medication immediately 3\. \*\*What is the typical reduction in HbA1c achieved with DPP-4 inhibitors?\*\* \- A. 0.5-0.7% \- B. 1.0-1.5% \- C. 1.5-2.0% \- D. 2.5-3.0% \*\*Answer:\*\* A. 0.5-0.7% \-\-- \#\#\# \*\*Slide 48: DPP-4 Inhibitors - Cancer Risk\*\* 1\. \*\*What is the current consensus on the risk of cancer associated with DPP-4 inhibitors based on meta-analyses?\*\* \- A. No increased risk of cancer \- B. Increased risk of liver cancer \- C. Increased risk of colon cancer \- D. Decreased risk of lung cancer \*\*Answer:\*\* A. No increased risk of cancer 2\. \*\*Which of the following cancers showed a possible increase in risk with DPP-4 inhibitors in certain studies?\*\* \- A. Bladder cancer \- B. Pancreatic cancer \- C. Colon cancer \- D. Skin cancer \*\*Answer:\*\* A. Bladder cancer 3\. \*\*Which type of cancer was observed to have a reduced risk in some patients using DPP-4 inhibitors?\*\* \- A. Prostate cancer \- B. Colon cancer \- C. Lung cancer \- D. Breast cancer \*\*Answer:\*\* B. Colon cancer \-\-- \#\#\# \*\*Slide 49: SGLT-2 Inhibitors - Mechanism of Action\*\* 1\. \*\*What is the primary mechanism of action of SGLT-2 inhibitors?\*\* \- A. Inhibit glucose absorption in the intestines \- B. Increase glucose reabsorption in the kidney \- C. Block glucose reabsorption in the kidney, increasing urinary glucose excretion \- D. Stimulate insulin secretion from the pancreas \*\*Answer:\*\* C. Block glucose reabsorption in the kidney, increasing urinary glucose excretion 2\. \*\*What cardiovascular benefit is associated with SGLT-2 inhibitors in patients with Type 2 Diabetes?\*\* \- A. Reduces stroke risk \- B. Reduces major cardiovascular events and cardiovascular mortality \- C. Prevents arrhythmias \- D. Increases blood pressure \*\*Answer:\*\* B. Reduces major cardiovascular events and cardiovascular mortality 3\. \*\*Which condition can benefit from the renal protective effects of SGLT-2 inhibitors in patients with Type 2 Diabetes?\*\* \- A. Chronic liver disease \- B. Renal disease progression \- C. Glaucoma \- D. Peripheral neuropathy \*\*Answer:\*\* B. Renal disease progression \-\-- \#\#\# \*\*Slide 50: SGLT-2 Inhibitors - Adverse Effects\*\* 1\. \*\*Which of the following adverse effects is commonly associated with SGLT-2 inhibitors?\*\* \- A. Hypotension and volume depletion \- B. Hypertension and edema \- C. Weight gain and fluid retention \- D. Bradycardia and dizziness \*\*Answer:\*\* A. Hypotension and volume depletion 2\. \*\*Which of the following genitourinary infections is more likely to occur in patients taking SGLT-2 inhibitors?\*\* \- A. Urinary tract infections and genital mycotic infections \- B. Respiratory infections \- C. Skin infections \- D. Eye infections \*\*Answer:\*\* A. Urinary tract infections and genital mycotic infections 3\. \*\*What is a rare but serious side effect associated with the use of SGLT-2 inhibitors, particularly canagliflozin?\*\* \- A. Bladder cancer \- B. Amputation risk \- C. Pancreatitis \- D. Myocardial infarction \*\*Answer:\*\* B. Amputation risk