Antidiabetics Flashcards
Mr B (59 years old) has T2DM, which was identified after an myocardial infarction. His recent HbA1c was well above target. He currently takes:
canagliflozin 100mg tablets 1OM
He tolerates this well.
Recent RFTs reported an eGFR of 99mL/min/1.73m2.
It is appropriate for you to suggest an increase in his canagliflozin to 2 tablets OM?
True/false?
True
Mr P (56 years old) has well established T2DM, for which he takes metformin 500mg tablets 1 with breakfast and lunch and 2 with evening meal, and more recently gliclazide 80mg tablets 2 BD. His recent HbA1c reading was 51mmol/mol (6.8%).
Since starting the the gliclazide he complains that he has put on weight, his BMI today is 29.
His QRISK2 score is 9%.
Which would be the MOST appropriate next step from the options listed below?
Select one or more:
a.
Add dapagliflozin 10mg tablets 1OD
b.
Swap gliclazide for pioglitazone 15mg tablets 1OD
c.
Add pioglitazone 15mg tablets 1OD
d.
Add sitagliptin 100mg tables 1OD
e.
Swap gliclazide for sitagliptin 100mg tablets 1 OD
f.
Swap gliclazide for dapagliflozin 10mg tablets 1OD
E. Swap gliclazide for sitagliptin 100mg tablets 1 OD
Patient has no established CVD/low QRisk.
Consider alternative second line txt i.e. DPP4i, to swap with SU, which has caused weight gain despite controlling glucose levels.
Avoid pioglitazone as can also cause weight gain.
Miss H (76 years old) is a frail patient, with multiple long term conditions including chronic heart failure and T2DM, for which she recently (3 months ago) started on metformin. She has tolerated metformin well and now regularly takes 500mg TDS. Her recent HbA1c reading was 60mmol/mol (7.6%).
Her BMI is 20.
Which would be the MOST appropriate next step medicine from those listed below?
Select one:
a.
Dapagliflozin 10mg tablets 1OD
b.
Sitagliptin 100mg tablets 1 OD
c.
Pioglitazone 15mg tablets, 1OD
d.
Gliclazide 80mg tablets 1OM
a.
Dapagliflozin 10mg tablets 1OD
Patient has established CVD.
Mr T (67 years old) takes gliclazide 80mg tablets 2OM.
His most recent HbA1c reading was 53mmol/mol (7.0%).
His diabetic treatment should remain the same, step up or step down?
His diabetic treatment should [remain the same].
Mr B (58 years old) is struggling to control his type 2 diabetes. He currently takes:
Janumet (50/1000mg) tablets 1BD
He is a lorry driver, so does not want to take any medicines that will affect his ability to drive.
His BMI is 34.
The most appropriate suggestion would be to add a Pioglitazone, sulfonylurea, or SGLT?
The correct answer is:
The most appropriate suggestion would be to add a [GLP‑1 mimetic]
Mr L (71 years old) is a frail patient, with bladder cancer, COPD and T2DM, for which he takes metformin 500mg TDS. His recent HbA1c reading was 60mmol/mol (7.6%).
His BMI is 17 and recent QRisk2 score is 7%.
He has a recent hospital admission for a fall.
Which would be the MOST appropriate next step medicine from those listed below?
Select one or more:
a.
Gliclazide 80mg tablets 1OM
b.
Sitagliptin 100mg tablets 1 OD
c.
Pioglitazone 15mg tablets, 1OD
d.
Dapagliflozin 10mg tablets 1OD
(b)Sitagliptin 100mg tablets 1 OD
Mrs H (45 years old) is currently taking metformin 1g MR tablets, 1 BD.
Her latest HbA1c reading was 45 mmol/mol (6.3).
In your opinion should her diabetic treatment remain the same, step up or down?
Remain the step
