Adverse Effects

Question 1

Metformin

Answer 1

GI (nausea, vomiting, diarrhea, flatulence)
- take with food & titrate dose

Vitamin B12 Deficiency
- monitor annually
- provide supplementation especially in anemia & peripheral neuropathy

Contraindicated in Lactic Acidosis
- Renal Dysfunction
- Unstable, hospitalized, HF
- Alcoholics (avoid in heavy drinkers)
- Post MI
- COPD
- Shock
- Hepatic Failure
- Surgery/Radiologic Procedure with contrasting dye (hold 1-2 days before and 2 days after)

Question 2

Alogliptin/Sitagliptin

Answer 2

N/v/d

Pancreatitis

HF

Joint Pain

decrease WBC count –> increased risk of infections/cancer

Question 3

Dulaglutide/Liraglutide/Semaglutide

Answer 3

GI (nausea, vomiting, diarrhea)
- titrate dose

Acute Pancreatitis
- avoid use in patients with chronic pancreatitis

Risk of Thyroid C-Cell Tumors
- contraindicated in patients with or FH of medullary thyroid cancer or MEN2

Gall Bladder Disease
- avoid use in patients with preexisting gallbladder disease

Gastroparesis (nausea & bloating)
- avoid use in patients

Retinopathy (cataracts, glaucoma, blurred vision, hemorrhages)
- avoid in patients

Question 4

Dapagliflozin/Empagliflozin/Canagliflozin

Answer 4

UTI

Female/Male Genital Infections

Hypotension

Increased cholesterol

Increased urination (take it in the morning)

Hyperkalemia

DKA

Bone Fractures

AKI

Leg/Foot Amputations

Question 5

Glipizide

Answer 5

Hypoglycemia

GI

Weight Gain

ER Distress (loss of function)

Question 6

Pioglitazone

Answer 6

Contraindicated in Class 3 and 4 HF

Risk of hepatotoxicity (check liver function)

Risk of bladder cancer

Fracture Risk