10 Thera VI Adams Midterm Questions

Question 1

A patient is on glyburide. What is most likely to happen?

Answer 1

Good bioavailability, hepatic disease is not a problem, a metabolite of glyburide can accumulate in renal disease leading to hypoglycemia, glyburide does not accumulate in renal disease

Question 2

A patient is on metformin. What is most likely to happen?

Answer 2

Bioavailability may be low leading to ketoacidosis, not metabolized in the liver, accumulates in renal disease leading to hypoglycemia, lactic acidosis in hepatic and cardiovascular disease

Question 3

A patient is on rosiglitazone. What is most likely to happen?

Answer 3

Bioavailability is good, inactive metabolites, safe in renal disease, clearance decreases in hepatic disease leading to hypoglycemia

Question 4

A patient is on repaglinide. What is most likely to happen?

Answer 4

Bioavailability can be low leading to ketoacidosis, metabolized by CYP3A4 to inactive metabolites, safe in renal disease, hepatic disease leads to hypoglycemia, salicylates inhibit repaglinide protein binding leading to hypoglycemia

Question 5

A patient is on exenatide. What is most likely to happen?

Answer 5

Safe in hepatic disease, decreases lovastatin levels leading to hypercholesterolemia, increases INR with warfarin leading to bleeding, renal disease leads to accumulation and hypoglycemia

Question 6

A patient is on insulin. What is most likely to happen?

Answer 6

Insulin has not active metabolites, renal disease leads to accumulation and hypoglycemia, hepatic disease leads to accumulation and hypoglycemia, insulin shock is severe hypoglycemia and coma