module 16 biguanides and TZD

Question 1

biguanide med

Answer 1

metformin

Question 2

metformin MOA

Answer 2

dec. hepatic glucose production
inhibit intestinal glucose absorption
inc. insulin sensitivity in muscle and fat
inc. insulin Rc binding

Question 3

metformin use

Answer 3

1st line therapy T2DM

Question 4

metformin AE

Answer 4

GI: diarrhea, nausea, abd. discomfort
- better with time
dec. vit. B12 absorption 
Rare: lactic acidosis w/ renal/cardiac dysfunction 
low risk hypoglycemia

Question 5

metformin admin

Answer 5

absorbed in SI

excreted unchanged renally

Question 6

metformin CI

Answer 6

discontinue with CrCl < 30mL/min

Question 7

metformin EDU

Answer 7

may dec. cardiovascular mortality

moderate-high A1C reduction: 1-2%

Question 8

thiazolidinediones (TZD) meds

Answer 8

pioglitazone

rosiglitazone

Question 9

TZD MOA

Answer 9

inc. insulin sensitivity
binds to PPAR-Y on adipose and vascular cells
-> regulate carb and lipid metabolism

Question 10

TZD AE

Answer 10

edema, fluid retention
wt. gain
low risk hypoglycemia
pioglitazone: inc. fx risk
rosiglitazone: inc. LDL

Question 11

TZD CI

Answer 11

symptomatic HF

Question 12

TZD admin

Answer 12

well-absorbed orally

Question 13

TZD EDU

Answer 13

pioglitazone: dec. TG, cardio benefit

modest A1C reduction: 1%