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Final Revision > The Rest of Antidiabetic Agents > Flashcards

The Rest of Antidiabetic Agents Flashcards

1
Q

True about Pramlintide:
a. Is a synthetic amylin analog.
b. Is a synthetic insulin analog.
c. Is a synthetic glucagon analog.
d. Is a synthetic somatostatin analog.

A

The correct answer is: a. Is a synthetic amylin analog.

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2
Q

Pramlintide is indicated as an adjunct to:
a. Basal insulin therapy in Type 1 or 2 diabetes.
b. Mealtime insulin therapy in Type 1 or 2 diabetes.
c. Oral hypoglycemic therapy in Type 1 or 2 diabetes.
d. Long-acting insulin therapy in Type 1 or 2 diabetes.

A

The correct answer is: b. Mealtime insulin therapy in Type 1 or 2 diabetes.

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3
Q

One of the effects of Pramlintide is to:
a. Increase gastric emptying.
b. Delay gastric emptying.
c. Increase postprandial glucagon secretion.
d. Decrease preprandial glucagon secretion.

A

The correct answer is: b. Delay gastric emptying.

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4
Q

Pramlintide decreases:
a. Preprandial insulin secretion.
b. Postprandial glucagon secretion.
c. Postprandial insulin secretion.
d. Preprandial glucagon secretion.

A

The correct answer is: b. Decreases postprandial glucagon secretion.

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5
Q

The route of administration for Pramlintide is:
a. Oral.
b. Intravenous.
c. Subcutaneous injection.
d. Intramuscular injection.

A

The correct answer is: c. Subcutaneous injection.

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6
Q

Pramlintide should be injected:
a. 30 minutes prior to meals.
b. Immediately prior to meals.
c. 30 minutes after meals.
d. 1 hour prior to meals.

A

The correct answer is: b. Immediately prior to meals.

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7
Q

When Pramlintide is initiated, the dose of rapid- or short-acting insulin should be decreased by 50% prior to meals to:
a. Increase insulin sensitivity.
b. Enhance the action of insulin.
c. Avoid a risk of severe hypoglycemia.
d. Increase glucose absorption.

A

The correct answer is: c. Avoid a risk of severe hypoglycemia.

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8
Q

The adverse effects of Pramlintide are mainly:
a. Neurological.
b. Gastrointestinal.
c. Dermatological.
d. Cardiovascular.

A

The correct answer is: b. Gastrointestinal.

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9
Q

The gastrointestinal adverse effects of Pramlintide consist of:
a. Diarrhea and flatulence.
b. Constipation and bloating.
c. Nausea, anorexia, and vomiting.
d. Abdominal pain and indigestion.

A

The correct answer is: c. Nausea, anorexia, and vomiting.

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10
Q

Pramlintide should not be given to patients with:
a. Renal impairment.
b. Diabetic gastroparesis.
c. Hyperthyroidism.
d. Cardiomyopathy.

A

The correct answer is: b. Diabetic gastroparesis.

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11
Q

Pramlintide should not be given to patients with a history of:
a. Hyperglycemia.
b. Hypoglycemic unawareness.
c. Hypertension.
d. Dyslipidemia.

A

The correct answer is: b. Hypoglycemic unawareness.

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12
Q

Sulfonylureas promote:
a. Glucagon release from the α cells of the pancreas.
b. Insulin release from the β cells of the pancreas.
c. Somatostatin release from the δ cells of the pancreas.
d. Amylin release from the β cells of the pancreas.

A

The correct answer is: b. Insulin release from the β cells of the pancreas.

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13
Q

The mechanism of action of sulfonylureas includes:
a. Inhibition of insulin release from the β cells.
b. Stimulation of insulin release from the β cells by blocking the ATP-sensitive K+ channels.
c. Inhibition of glucagon release from the α cells.
d. Stimulation of glucagon release from the α cells by blocking the ATP-sensitive K+ channels.

A

The correct answer is: b. Stimulation of insulin release from the β cells by blocking the ATP-sensitive K+ channels.

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14
Q

Blocking the ATP-sensitive K+ channels by sulfonylureas results in:
a. Hyperpolarization and Ca2+ efflux.
b. Depolarization and Ca2+ influx.
c. Hyperpolarization and Na+ influx.
d. Depolarization and Na+ efflux.

A

The correct answer is: b. Depolarization and Ca2+ influx.

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15
Q

Sulfonylureas may cause:
a. Hyperglycemia.
b. Hypoglycemia.
c. Hyperkalemia.
d. Hypokalemia.

A

The correct answer is: b. Hypoglycemia.

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16
Q

Another mechanism of action of sulfonylureas is:
a. Reduction in hepatic glucose production.
b. Increase in hepatic glucose production.
c. Reduction in renal glucose reabsorption.
d. Increase in renal glucose reabsorption.

A

The correct answer is: a. Reduction in hepatic glucose production.

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17
Q

Sulfonylureas also:
a. Decrease peripheral insulin sensitivity.
b. Increase peripheral insulin sensitivity.
c. Decrease peripheral glucose uptake.
d. Increase peripheral glucose production.

A

The correct answer is: b. Increase peripheral insulin sensitivity.

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18
Q

The first-generation sulfonylurea is:
a. Glipizide.
b. Glyburide.
c. Tolbutamide.
d. Glimepiride.

A

The correct answer is: c. Tolbutamide.

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19
Q

The action duration of Tolbutamide is:
a. Longest.
b. Shortest.
c. Intermediate.
d. Variable.

A

The correct answer is: b. Shortest.

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20
Q

Second-generation sulfonylureas have:
a. Shorter duration of action.
b. Longer duration of action.
c. No duration of action.
d. Intermediate duration of action.

A

The correct answer is: b. Longer duration of action.

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21
Q

Which of the following is a second-generation sulfonylurea?
a. Tolbutamide.
b. Glipizide.
c. Chlorpropamide.
d. Tolazamide.

A

The correct answer is: b. Glipizide.

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22
Q

Glyburide is:
a. A first-generation sulfonylurea.
b. A second-generation sulfonylurea.
c. An insulin analog.
d. A glucagon analog.

A

The correct answer is: b. A second-generation sulfonylurea.

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23
Q

True regarding Glyburide:
a. Is not safe in pregnancy.
b. Is reasonably safe alternative to insulin therapy for diabetes in pregnancy.
c. Has the shortest action among sulfonylureas.
d. Is a first-generation sulfonylurea.

A

The correct answer is: b. Is reasonably safe alternative to insulin therapy for diabetes in pregnancy.

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24
Q

Which of the following is a second-generation sulfonylurea?
a. Tolbutamide.
b. Glimepiride.
c. Chlorpropamide.
d. Tolazamide.

A

The correct answer is: b. Glimepiride.

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25
Q

One of the adverse effects of sulfonylureas is:
a. Weight loss.
b. Weight gain.
c. Hypertension.
d. Hyperglycemia.

A

The correct answer is: b. Weight gain.

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26
Q

Sulfonylureas may cause:
a. Hyperglycemia.
b. Hypoglycemia.
c. Hyperkalemia.
d. Hyponatremia.

A

The correct answer is: b. Hypoglycemia.

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27
Q

Renal impairment is a particular problem in agents metabolized to:
a. Inactive compounds.
b. Active compounds.
c. Hydrophilic compounds.
d. Lipophilic compounds.

A

The correct answer is: b. Active compounds.

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28
Q

An example of a sulfonylurea that can be problematic in renal impairment is:
a. Glipizide.
b. Glimepiride.
c. Glyburide.
d. Tolbutamide.

A

The correct answer is: c. Glyburide.

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29
Q

The action of Meglitinide analogs is dependent on:
a. Functioning pancreatic α cells.
b. Functioning pancreatic β cells.
c. Functioning hepatic cells.
d. Functioning renal cells.

A

The correct answer is: b. Functioning pancreatic β cells.

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30
Q

The mechanism of action (MOA) of Meglitinide analogs involves binding to a:
a. Non-specific site on the insulin receptor.
b. Distinct site on the glucagon receptor.
c. Distinct site on the sulfonylurea receptor of ATP-sensitive K+ channels.
d. Non-specific site on the ATP-sensitive Na+ channels.

A

The correct answer is: c. Distinct site on the sulfonylurea receptor of ATP-sensitive K+ channels.

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31
Q

Binding to the sulfonylurea receptor of ATP-sensitive K+ channels by Meglitinide analogs initiates a series of reactions culminating in:
a. The release of glucagon.
b. The release of insulin.
c. The inhibition of insulin.
d. The inhibition of glucagon.

A

The correct answer is: b. The release of insulin.

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32
Q

Meglitinides have a:
a. Rapid onset and a long duration of action.
b. Slow onset and a long duration of action.
c. Rapid onset and a short duration of action.
d. Slow onset and a short duration of action.

A

The correct answer is: c. Rapid onset and a short duration of action.

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33
Q

Compared to sulfonylureas, Meglitinides are:
a. Less effective in the early release of insulin.
b. More effective in the late release of insulin.
c. More effective in the early release of insulin.
d. Less effective in the postprandial release of insulin.

A

The correct answer is: c. More effective in the early release of insulin.

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34
Q

Meglitinides are effective in:
a. Preprandial glucose regulation.
b. Postprandial glucose regulation.
c. Basal glucose regulation.
d. Continuous glucose regulation.

A

The correct answer is: b. Postprandial glucose regulation.

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35
Q

Hypoglycemia with Meglitinides appears to be:
a. Higher than sulfonylureas.
b. Lower than sulfonylureas.
c. Equal to sulfonylureas.
d. Not comparable to sulfonylureas.

A

The correct answer is: b. Lower than sulfonylureas.

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36
Q

Meglitinides should not be used in combination with sulfonylureas because:
a. It causes severe hyperglycemia.
b. It causes severe hypoglycemia.
c. It decreases the effectiveness of insulin.
d. It increases the risk of ketoacidosis.

A

The correct answer is: b. It causes severe hypoglycemia.

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37
Q

Meglintides include:
a. Glipizide and Glyburide.
b. Repaglinide and Nateglinide.
c. Tolbutamide and Chlorpropamide.
d. Glimepiride and Tolazamide.

A

The correct answer is: b. Repaglinide and Nateglinide.

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38
Q

Repaglinide is a:
a. Sulfonylurea.
b. Biguanide.
c. Meglitinide.
d. Thiazolidinedione.

A

The correct answer is: c. Meglitinide.

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39
Q

Nateglinide is a:
a. Sulfonylurea.
b. Biguanide.
c. Meglitinide.
d. Thiazolidinedione.

A

The correct answer is: c. Meglitinide.

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40
Q

Drugs that inhibit CYP3A4 (such as ketoconazole, erythromycin, and clarithromycin) may:
a. Reduce the effect of repaglinide.
b. Enhance the effect of repaglinide.
c. Have no effect on repaglinide.
d. Decrease the absorption of repaglinide.

A

The correct answer is: b. Enhance the effect of repaglinide.

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41
Q

Caution should be used with CYP3A4 inhibitors in patients with:
a. Renal impairment.
b. Cardiac impairment.
c. Hepatic impairment.
d. Respiratory impairment.

A

The correct answer is: c. Hepatic impairment.

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42
Q

CYP3A4 inducers (such as barbiturates, carbamazepine, and rifampin) will:
a. Increase the effect of repaglinide.
b. Decrease the effect of repaglinide.
c. Have no effect on repaglinide.
d. Enhance the absorption of repaglinide.

A

The correct answer is: b. Decrease the effect of repaglinide.

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43
Q

Which of the following is a CYP3A4 inducer that decreases the effect of repaglinide?
a. Ketoconazole.
b. Erythromycin.
c. Barbiturates.
d. Clarithromycin.

A

The correct answer is: c. Barbiturates.

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44
Q

Ketoconazole is a CYP3A4:
a. Inducer that decreases the effect of repaglinide.
b. Inhibitor that enhances the effect of repaglinide.
c. Inducer that has no effect on repaglinide.
d. Inhibitor that decreases the absorption of repaglinide.

A

The correct answer is: b. Inhibitor that enhances the effect of repaglinide.

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45
Q

Erythromycin is a CYP3A4:
a. Inducer that decreases the effect of repaglinide.
b. Inhibitor that enhances the effect of repaglinide.
c. Inducer that has no effect on repaglinide.
d. Inhibitor that decreases the absorption of repaglinide.

A

The correct answer is: b. Inhibitor that enhances the effect of repaglinide.

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46
Q

Clarithromycin is a CYP3A4:
a. Inducer that decreases the effect of repaglinide.
b. Inhibitor that enhances the effect of repaglinide.
c. Inducer that has no effect on repaglinide.
d. Inhibitor that decreases the absorption of repaglinide.

A

The correct answer is: b. Inhibitor that enhances the effect of repaglinide.

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47
Q

Barbiturates are CYP3A4:
a. Inhibitors that enhance the effect of repaglinide.
b. Inducers that decrease the effect of repaglinide.
c. Inhibitors that decrease the absorption of repaglinide.
d. Inducers that have no effect on repaglinide.

A

The correct answer is: b. Inducers that decrease the effect of repaglinide.

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48
Q

Carbamazepine is a CYP3A4:
a. Inhibitor that enhances the effect of repaglinide.
b. Inducer that decreases the effect of repaglinide.
c. Inhibitor that decreases the absorption of repaglinide.
d. Inducer that has no effect on repaglinide.

A

The correct answer is: b. Inducer that decreases the effect of repaglinide.

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49
Q

Rifampin is a CYP3A4:
a. Inhibitor that enhances the effect of repaglinide.
b. Inducer that decreases the effect of repaglinide.
c. Inhibitor that decreases the absorption of repaglinide.
d. Inducer that has no effect on repaglinide.

A

The correct answer is: b. Inducer that decreases the effect of repaglinide.

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50
Q

Compared to sulfonylureas, Meglitinides have:
a. More severe weight gain issues.
b. Less severe weight gain issues.
c. Equal weight gain issues.
d. No weight gain issues.

A

The correct answer is: b. Less severe weight gain issues.

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51
Q

The only drug member of the biguanides is:
a. Pioglitazone.
b. Rosiglitazone.
c. Metformin.
d. Glipizide.

A

The correct answer is: c. Metformin.

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52
Q

Metformin increases glucose uptake by target tissues, thereby:
a. Increasing insulin secretion.
b. Decreasing insulin resistance.
c. Enhancing glycogenolysis.
d. Reducing gluconeogenesis.

A

The correct answer is: b. Decreasing insulin resistance.

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53
Q

Metformin requires insulin for its:
a. Absorption.
b. Distribution.
c. Action.
d. Metabolism.

A

The correct answer is: c. Action.

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54
Q

True regarding metformin:
a. It promotes insulin secretion.
b. It requires insulin for its action.
c. It decreases glucose uptake by tissues.
d. It increases insulin resistance.

A

The correct answer is: b. It requires insulin for its action.

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55
Q

Metformin does NOT promote:
a. Insulin secretion.
b. Glucose uptake.
c. Insulin sensitivity.
d. Gluconeogenesis inhibition.

A

The correct answer is: a. Insulin secretion.

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56
Q

The main mechanisms of action of metformin include all EXCEPT:
a. Inhibiting hepatic gluconeogenesis.
b. Slowing intestinal absorption of sugars.
c. Improving peripheral glucose uptake and utilization.
d. Increasing insulin secretion.

A

The correct answer is: d. Increasing insulin secretion.

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57
Q

Metformin inhibits:
a. Hepatic gluconeogenesis.
b. Peripheral glucose uptake.
c. Glycogen synthesis.
d. Insulin secretion.

A

The correct answer is: a. Hepatic gluconeogenesis.

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58
Q

Metformin slows:
a. Intestinal absorption of sugars.
b. Renal clearance.
c. Hepatic glycogen synthesis.
d. Peripheral glucose uptake.

A

The correct answer is: a. Intestinal absorption of sugars.

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59
Q

Metformin improves:
a. Hepatic glucose production.
b. Peripheral glucose uptake and utilization.
c. Insulin secretion.
d. Glycogen synthesis in the liver.

A

The correct answer is: b. Peripheral glucose uptake and utilization.

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60
Q

Metformin reduces:
a. HDL and increases LDL.
b. LDL, VLDL, and increases HDL.
c. Insulin sensitivity.
d. Hepatic glucose production only.

A

The correct answer is: b. LDL, VLDL, and increases HDL.

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61
Q

The effects of metformin on lipoproteins need how many weeks of use?
a. 1 to 2 weeks.
b. 2 to 3 weeks.
c. 4 to 6 weeks.
d. 6 to 8 weeks.

A

The correct answer is: c. 4 to 6 weeks.

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62
Q

A common side effect of metformin is:
a. Weight gain.
b. Loss of appetite leading to weight loss.
c. Increased appetite.
d. Constipation.

A

The correct answer is: b. Loss of appetite leading to weight loss.

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63
Q

Metformin is recommended as the drug of choice for:
a. Type 1 diabetics.
b. Type 2 diabetics.
c. Gestational diabetes.
d. Diabetes insipidus.

A

The correct answer is: b. Type 2 diabetics.

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64
Q

Metformin is:
a. Metabolized in the liver and excreted unchanged renally.
b. Metabolized in the liver and excreted through bile.
c. Not metabolized in the liver but excreted unchanged renally.
d. Not metabolized in the liver but excreted through bile.

A

The correct answer is: c. Not metabolized in the liver but excreted unchanged renally.

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65
Q

True regarding the metabolism of metformin:
a. It is metabolized in the liver.
b. It undergoes extensive first-pass metabolism.
c. It is excreted unchanged renally.
d. It is excreted through the bile.

A

The correct answer is: c. It is excreted unchanged renally.

66
Q

Metformin is effective in the treatment of polycystic ovary disease due to its ability to:
a. Increase insulin secretion.
b. Decrease glucose absorption.
c. Lower insulin resistance.
d. Increase hepatic gluconeogenesis.

A

The correct answer is: c. Lower insulin resistance.

67
Q

The effectiveness of metformin in polycystic ovary disease can result in:
a. Weight gain.
b. Decreased appetite.
c. Ovulation and possibly pregnancy.
d. Increased insulin resistance.

A

The correct answer is: c. Ovulation and possibly pregnancy.

68
Q

Metformin helps in polycystic ovary disease by:
a. Increasing glucose uptake.
b. Lowering insulin resistance, leading to ovulation.
c. Promoting insulin secretion.
d. Enhancing hepatic gluconeogenesis.

A

The correct answer is: b. Lowering insulin resistance, leading to ovulation.

69
Q

The primary adverse effects of metformin are related to:
a. Hepatic toxicity.
b. Renal impairment.
c. Gastrointestinal disturbance.
d. Cardiovascular issues.

A

The correct answer is: c. Gastrointestinal disturbance.

70
Q

Metformin is contraindicated in:
a. Renal and hepatic disease.
b. Hypertension.
c. Mild infection.
d. Hypoglycemia.

A

The correct answer is: a. Renal and hepatic disease.

71
Q

Metformin should not be used in patients with renal and hepatic disease because of the risk of:
a. Hyperglycemia.
b. Lactic acidosis.
c. Weight gain.
d. Increased appetite.

A

The correct answer is: b. Lactic acidosis.

72
Q

Metformin is contraindicated in which of the following conditions?
a. Acute MI and CHF.
b. Hypertension.
c. Mild infection.
d. Hypoglycemia.

A

The correct answer is: a. Acute MI and CHF.

73
Q

Metformin is not recommended for patients with:
a. Severe infection.
b. Mild infection.
c. Hypertension.
d. Hypoglycemia.

A

The correct answer is: a. Severe infection.

74
Q

Metformin should be avoided in patients with:
a. Diabetic ketoacidosis.
b. Mild hypoglycemia.
c. Hypertension.
d. Mild renal impairment.

A

The correct answer is: a. Diabetic ketoacidosis.

75
Q

Lactic acidosis has occurred in patients taking:
a. Sulfonylureas.
b. Metformin.
c. Insulin.
d. DPP-4 inhibitors.

A

The correct answer is: b. Metformin.

76
Q

Long-term use of metformin may interfere with the absorption of:
a. Vitamin D.
b. Vitamin B12.
c. Vitamin C.
d. Vitamin K.

A

The correct answer is: b. Vitamin B12.

77
Q

Compared to sulfonylurea, metformin has a lower risk of:
a. Hyperglycemia.
b. Hypoglycemia.
c. Weight gain.
d. Gastrointestinal disturbance

A

The correct answer is: b. Hypoglycemia.

78
Q

The hypoglycemic risk with metformin is less than with sulfonylureas because metformin:
a. Promotes insulin secretion.
b. Does not promote insulin secretion.
c. Increases glucose absorption.
d. Inhibits hepatic glucose production.

A

The correct answer is: b. Does not promote insulin secretion.

79
Q

Insulin is required for the action of thiazolidinediones but does not:
a. Increase insulin secretion.
b. Decrease insulin resistance.
c. Improve glucose uptake.
d. Promote its secretion.

A

The correct answer is: d. Promote its secretion.

80
Q

Two members of the thiazolidinediones class are:
a. Metformin and Glipizide.
b. Pioglitazone and Rosiglitazone.
c. Glyburide and Glimepiride.
d. Sitagliptin and Saxagliptin.

A

The correct answer is: b. Pioglitazone and Rosiglitazone.

81
Q

Which of the following is a member of the thiazolidinediones class?
a. Metformin.
b. Pioglitazone.
c. Glyburide.
d. Sitagliptin.

A

The correct answer is: b. Pioglitazone.

82
Q

Which drug belongs to the thiazolidinediones class?
a. Glipizide.
b. Rosiglitazone.
c. Metformin.
d. Glimepiride.

A

The correct answer is: b. Rosiglitazone.

83
Q

The mechanism of action (MOA) of thiazolidinediones involves targeting the:
a. PPARγ receptor.
b. GABA receptor.
c. GLP-1 receptor.
d. Insulin receptor.

A

The correct answer is: a. PPARγ receptor.

84
Q

Thiazolidinediones target the PPARγ receptor, which is a:
a. Membrane receptor.
b. Enzyme.
c. Nuclear hormone receptor.
d. Ion channel.

A

The correct answer is: c. Nuclear hormone receptor.

85
Q

The activation of PPARγ by thiazolidinediones helps to regulate:
a. Protein synthesis.
b. Fat and glucose metabolism.
c. Amino acid absorption.
d. Calcium homeostasis.

A

The correct answer is: b. Fat and glucose metabolism.

86
Q

Thiazolidinediones increase insulin sensitivity in:
a. Adipose tissue, liver, and skeletal muscle.
b. Kidneys, pancreas, and intestines.
c. Brain, heart, and lungs.
d. Stomach, spleen, and gallbladder.

A

The correct answer is: a. Adipose tissue, liver, and skeletal muscle.

87
Q

The primary target of thiazolidinediones in improving insulin sensitivity is:
a. Renal tissue.
b. Neural tissue.
c. Adipose tissue.
d. Bone tissue.

A

The correct answer is: c. Adipose tissue.

88
Q

LDL is not affected by which thiazolidinedione?
a. Rosiglitazone.
b. Pioglitazone.
c. Metformin.
d. Glimepiride.

A

The correct answer is: b. Pioglitazone.

89
Q

LDL levels have increased with the use of which thiazolidinedione?
a. Pioglitazone.
b. Rosiglitazone.
c. Metformin.
d. Glipizide.

A

The correct answer is: b. Rosiglitazone.

90
Q

The increase in LDL with rosiglitazone is associated with:
a. Decreased cardiovascular toxicity.
b. Increased cardiovascular toxicity and water retention.
c. Enhanced insulin secretion.
d. Decreased insulin sensitivity.

A

The correct answer is: b. Increased cardiovascular toxicity and water retention.

91
Q

HDL levels increase with:
a. Pioglitazone only.
b. Rosiglitazone only.
c. Both pioglitazone and rosiglitazone.
d. Neither pioglitazone nor rosiglitazone.

A

The correct answer is: c. Both pioglitazone and rosiglitazone.

92
Q

Both pioglitazone and rosiglitazone affect which lipoprotein?
a. Decrease LDL.
b. Increase HDL.
c. Increase triglycerides.
d. Decrease VLDL.

A

The correct answer is: b. Increase HDL.

93
Q

Thiazolidinediones lead to redistribution of fat from:
a. Subcutaneous to visceral tissues.
b. Visceral to subcutaneous tissues.
c. Skeletal muscle to liver.
d. Adipose tissue to muscle.

A

The correct answer is: b. Visceral to subcutaneous tissues.

94
Q

The redistribution of fat by thiazolidinediones results in:
a. Weight loss.
b. Weight gain.
c. Muscle hypertrophy.
d. Decreased appetite.

A

The correct answer is: b. Weight gain.

95
Q

The effect of thiazolidinediones on fat distribution is primarily seen in:
a. Increased visceral fat.
b. Decreased subcutaneous fat.
c. Increased subcutaneous fat.
d. Decreased liver fat.

A

The correct answer is: c. Increased subcutaneous fat.

96
Q

Glitazones are recommended as a second-line alternative for patients who:
a. Are newly diagnosed with diabetes.
b. Fail or have contraindications to metformin therapy.
c. Have gestational diabetes.
d. Are controlled on insulin therapy.

A

The correct answer is: b. Fail or have contraindications to metformin therapy.

97
Q

Both pioglitazone and rosiglitazone are:
a. Poorly absorbed from the GIT.
b. Absorbed well from the GIT.
c. Metabolized in the liver.
d. Excreted unchanged in urine.

A

The correct answer is: b. Absorbed well from the GIT.

98
Q

It is recommended that thiazolidinediones:
a. Be used in nursing mothers.
b. NOT be used in nursing mothers.
c. Be used in children.
d. Be used in pregnant women.

A

The correct answer is: b. NOT be used in nursing mothers.

99
Q

Relief of insulin resistance by thiazolidinediones causes ovulation to resume in:
a. Postmenopausal women.
b. Menopausal women.
c. Premenopausal women with polycystic ovary syndrome.
d. All women.

A

The correct answer is: c. Premenopausal women with polycystic ovary syndrome.

100
Q

Women taking oral contraceptives and thiazolidinediones may become pregnant because:
a. Thiazolidinediones increase the efficacy of contraceptives.
b. Thiazolidinediones have been shown to reduce plasma concentrations of the estrogen-containing contraceptives.
c. Thiazolidinediones promote ovulation.
d. Thiazolidinediones cause weight loss.

A

The correct answer is: b. Thiazolidinediones have been shown to reduce plasma concentrations of the estrogen-containing contraceptives.

101
Q

The use of thiazolidinediones in nursing mothers is:
a. Recommended.
b. Safe.
c. Not recommended.
d. Beneficial.

A

The correct answer is: c. Not recommended.

102
Q

Thiazolidinediones affect the plasma concentrations of estrogen-containing contraceptives by:
a. Increasing their efficacy.
b. Increasing their concentration.
c. Reducing their concentration.
d. Not affecting their concentration.

A

The correct answer is: c. Reducing their concentration.

103
Q

In women with polycystic ovary syndrome, thiazolidinediones help in:
a. Weight loss.
b. Promoting insulin resistance.
c. Resuming ovulation.
d. Increasing glucose absorption.

A

The correct answer is: c. Resuming ovulation.

104
Q

One of the adverse effects of thiazolidinediones is:
a. High incidence of liver toxicity.
b. Very few cases of liver toxicity.
c. Severe gastrointestinal disturbance.
d. Neuropathy.

A

The correct answer is: b. Very few cases of liver toxicity.

105
Q

Thiazolidinediones are associated with:
a. Weight loss.
b. Weight increase.
c. Stable weight.
d. No change in weight.

A

The correct answer is: b. Weight increase.

106
Q

A notable adverse effect of thiazolidinediones is:
a. Osteopenia and increased fracture risk.
b. Increased muscle mass.
c. Decreased bone density.
d. Increased calcium absorption.

A

The correct answer is: a. Osteopenia and increased fracture risk.

107
Q

Thiazolidinediones may increase the risk of:
a. Myocardial infarction and death.
b. Hypertension.
c. Renal failure.
d. Neurological disorders.

A

The correct answer is: a. Myocardial infarction and death.

108
Q

Thiazolidinediones are known to cause:
a. Severe hepatic failure.
b. Weight increase.
c. Increased risk of fractures.
d. Both b and c.

A

The correct answer is: d. Both b and c.

109
Q

Which of the following is a potential adverse effect of thiazolidinediones?
a. Hypoglycemia.
b. Increased fracture risk.
c. Hypotension.
d. Neuropathy.

A

The correct answer is: b. Increased fracture risk.

110
Q

An increased risk of which condition is associated with thiazolidinediones?
a. Stroke.
b. Myocardial infarction.
c. Pulmonary embolism.
d. Deep vein thrombosis.

A

The correct answer is: b. Myocardial infarction.

111
Q

Thiazolidinediones have been reported to cause:
a. Decreased bone density.
b. Liver cancer.
c. Neuropathy.
d. Increased blood pressure.

A

The correct answer is: a. Decreased bone density.

112
Q

The weight increase associated with thiazolidinediones can be attributed to:
a. Increased muscle mass.
b. Fluid retention and fat accumulation.
c. Enhanced metabolic rate.
d. Increased appetite.

A

The correct answer is: b. Fluid retention and fat accumulation.

113
Q

Which of the following is a member of the α-glucosidase inhibitor drug class?
a. Metformin.
b. Rosiglitazone.
c. Acarbose.
d. Glyburide.

A

The correct answer is: c. Acarbose.

114
Q

Which of the following drugs is also an α-glucosidase inhibitor along with acarbose?
a. Miglitol.
b. Glipizide.
c. Pioglitazone.
d. Sitagliptin.

A

The correct answer is: a. Miglitol.

115
Q

α-Glucosidase inhibitors are used for the treatment of which type of diabetes?
a. Type 1 diabetes.
b. Type 2 diabetes.
c. Gestational diabetes.
d. Prediabetes.

A

The correct answer is: b. Type 2 diabetes.

116
Q

When are α-glucosidase inhibitors taken to maximize their effect?
a. Before bedtime.
b. With meals.
c. At the beginning of meals.
d. After meals.

A

The correct answer is: c. At the beginning of meals.

117
Q

How do α-glucosidase inhibitors help in managing blood glucose levels?
a. By increasing insulin sensitivity.
b. By delaying the digestion of carbohydrates.
c. By increasing insulin secretion.
d. By decreasing glucose absorption in the kidneys.

A

The correct answer is: b. By delaying the digestion of carbohydrates.

118
Q

What is the result of taking α-glucosidase inhibitors in terms of glucose levels?
a. Lower fasting glucose levels.
b. Lower postprandial glucose levels.
c. Higher fasting glucose levels.
d. Higher postprandial glucose levels.

A

The correct answer is: b. Lower postprandial glucose levels.

119
Q

How do α-glucosidase inhibitors work at the intestinal brush border?
a. By reversibly inhibiting α-glucosidase.
b. By irreversibly inhibiting α-glucosidase.
c. By inhibiting pancreatic β-cells.
d. By stimulating insulin secretion.

A

The correct answer is: a. By reversibly inhibiting α-glucosidase.

120
Q

What is the role of the enzyme α-glucosidase in carbohydrate digestion?
a. Hydrolyzes oligosaccharides to glucose.
b. Converts glucose to glycogen.
c. Inhibits glucose absorption.
d. Stimulates insulin release.

A

The correct answer is: a. Hydrolyzes oligosaccharides to glucose.

121
Q

In addition to α-glucosidase, what other enzyme do these inhibitors affect?
a. β-amylase.
b. γ-amylase.
c. α-amylase.
d. δ-amylase.

A

The correct answer is: c. α-amylase.

122
Q

What is the function of pancreatic α-amylase in the digestive process?
a. It digests proteins.
b. It hydrolyzes complex carbohydrates.
c. It emulsifies fats.
d. It stimulates bile production.

A

The correct answer is: b. It hydrolyzes complex carbohydrates.

123
Q

How is acarbose absorbed in the body?
a. Rapidly absorbed.
b. Poorly absorbed.
c. Completely absorbed.
d. Not absorbed.

A

The correct answer is: b. Poorly absorbed.

124
Q

How is miglitol absorbed in the body?
a. Poorly absorbed.
b. Rapidly absorbed.
c. Very well absorbed but has systemic effects.
d. Very well absorbed but has no systemic effects.

A

The correct answer is: d. Very well absorbed but has no systemic effects.

125
Q

What are the major side effects of α-glucosidase inhibitors?
a. Nausea, vomiting, and headache.
b. Flatulence, diarrhea, and abdominal cramping.
c. Dizziness, dry mouth, and fatigue.
d. Rash, itching, and swelling.

A

The correct answer is: b. Flatulence, diarrhea, and abdominal cramping.

126
Q

Why do α-glucosidase inhibitors cause gastrointestinal side effects such as flatulence, diarrhea, and abdominal cramping?
a. Due to their effect on gastric emptying.
b. Due to their inhibition of digestive enzymes in the stomach.
c. Due to undigested carbohydrates reaching the colon.
d. Due to increased gastric acid production.

A

The correct answer is: c. Due to undigested carbohydrates reaching the colon.

127
Q

Which patients should avoid using α-glucosidase inhibitors?
a. Patients with type 1 diabetes.
b. Patients with cardiovascular disease.
c. Patients with inflammatory bowel disease, colonic ulceration, or intestinal obstruction.
d. Patients with renal and hepatic impairment.

A

The correct answer is: c. Patients with inflammatory bowel disease, colonic ulceration, or intestinal obstruction.

128
Q

Which of the following drugs is a DPP-IV inhibitor?
a. Metformin.
b. Sitagliptin.
c. Glipizide.
d. Rosiglitazone.

A

The correct answer is: b. Sitagliptin.

129
Q

How does sitagliptin function in diabetes management?
a. By inhibiting glucose absorption in the intestines.
b. By orally inhibiting the enzyme DPP-IV.
c. By increasing insulin secretion directly.
d. By delaying gastric emptying.

A

The correct answer is: b. By orally inhibiting the enzyme DPP-IV.

130
Q

What is the role of DPP-IV in the body?
a. Inactivation of insulin.
b. Inactivation of incretin hormones.
c. Stimulation of glucagon release.
d. Promotion of glucose absorption.

A

The correct answer is: b. Inactivation of incretin hormones.

131
Q

Which incretin hormone is inactivated by DPP-IV?
a. Insulin.
b. Glucagon-like peptide-1 (GLP-1).
c. Amylin.
d. Somatostatin.

A

The correct answer is: b. Glucagon-like peptide-1 (GLP-1).

132
Q

How does sitagliptin affect incretin hormones?
a. It stimulates their release.
b. It prevents their inactivation.
c. It enhances their breakdown.
d. It decreases their production.

A

The correct answer is: b. It prevents their inactivation.

133
Q

What are the effects of sitagliptin on insulin and glucagon?
a. Decreased insulin release and increased glucagon secretion.
b. Increased insulin release and reduction in inappropriate glucagon secretion.
c. No effect on insulin or glucagon.
d. Increased insulin and glucagon release.

A

The correct answer is: b. Increased insulin release and reduction in inappropriate glucagon secretion.

134
Q

How is sitagliptin absorbed in the body?
a. Poorly absorbed.
b. Well absorbed after oral administration.
c. Not absorbed.
d. Absorbed only in the presence of food.

A

The correct answer is: b. Well absorbed after oral administration.

135
Q

How is sitagliptin primarily excreted from the body?
a. Metabolized in the liver.
b. Excreted unchanged in the urine.
c. Excreted in bile.
d. Metabolized in the intestines.

A

The correct answer is: b. Excreted unchanged in the urine.

136
Q

What is recommended for patients with renal dysfunction taking sitagliptin?
a. No adjustment needed.
b. Increase the dosage.
c. Dosage adjustments are recommended.
d. Discontinue the drug.

A

The correct answer is: c. Dosage adjustments are recommended.

137
Q

What are the most common adverse effects of sitagliptin?
a. Nausea and vomiting.
b. Nasopharyngitis and headache.
c. Dizziness and dry mouth.
d. Rash and itching.

A

The correct answer is: b. Nasopharyngitis and headache.

138
Q

What is the rate of hypoglycemia in patients taking sitagliptin?
a. High.
b. Moderate.
c. Low.
d. Very low.

A

The correct answer is: d. Very low.

139
Q

How does oral glucose affect insulin secretion compared to intravenous glucose in normal individuals?
a. Oral glucose results in lower insulin secretion.
b. Oral glucose results in higher insulin secretion.
c. Intravenous glucose results in higher insulin secretion.
d. Both result in the same insulin secretion.

A

The correct answer is: b. Oral glucose results in higher insulin secretion.

140
Q

What is this phenomenon of higher insulin secretion with oral glucose known as?
a. Glucose tolerance effect.
b. Incretin effect.
c. Insulin sensitivity.
d. Glucagon suppression.

A

The correct answer is: b. Incretin effect.

141
Q

In which type of diabetes is the incretin effect reduced?
a. Type 1 diabetes.
b. Type 2 diabetes.
c. Gestational diabetes.
d. Prediabetes.

A

The correct answer is: b. Type 2 diabetes.

142
Q

What type of drug is exenatide?
a. Insulin analog.
b. GLP-1 receptor agonist.
c. Incretin mimetic.
d. DPP-IV inhibitor.

A

The correct answer is: c. Incretin mimetic.

143
Q

What is the effect of exenatide on glucose-dependent insulin secretion?
a. It decreases insulin secretion.
b. It improves glucose-dependent insulin secretion.
c. It has no effect on insulin secretion.
d. It inhibits insulin secretion

A

The correct answer is: b. It improves glucose-dependent insulin secretion.

144
Q

How does exenatide affect gastric emptying time?
a. Increases gastric emptying time.
b. No effect on gastric emptying time.
c. Slows gastric emptying time.
d. Enhances gastric emptying.

A

The correct answer is: c. Slows gastric emptying time.

145
Q

What is the impact of exenatide on food intake?
a. Increases food intake.
b. Decreases food intake.
c. No effect on food intake.
d. Changes food preferences.

A

The correct answer is: b. Decreases food intake.

146
Q

What is the effect of exenatide on postprandial glucagon secretion?
a. Increases glucagon secretion.
b. No effect on glucagon secretion.
c. Decreases postprandial glucagon secretion.
d. Stimulates glucagon production.

A

The correct answer is: c. Decreases postprandial glucagon secretion.

147
Q

What is the effect of exenatide on β-cell proliferation?
a. Inhibits β-cell proliferation.
b. Promotes β-cell proliferation.
c. No effect on β-cell proliferation.
d. Reduces β-cell proliferation.

A

The correct answer is: b. Promotes β-cell proliferation.

148
Q

What are the consequences of exenatide administration on weight gain and hyperglycemia?
a. Weight gain and postprandial hyperglycemia are reduced.
b. Weight gain and postprandial hyperglycemia are increased.
c. Weight gain is increased, and hyperglycemia is reduced.
d. Weight gain is reduced, and hyperglycemia is increased.

A

The correct answer is: a. Weight gain and postprandial hyperglycemia are reduced.

149
Q

When should exenatide be administered relative to meals?
a. After meals.
b. Before meals.
c. With meals.
d. Between meals.

A

The correct answer is: b. Before meals.

150
Q

How is exenatide administered?
a. Orally.
b. Intravenously.
c. Subcutaneously.
d. Intramuscularly.

A

The correct answer is: c. Subcutaneously.

151
Q

What is the main composition of exenatide?
a. Polysaccharide.
b. Polypeptide.
c. Lipid.
d. Nucleic acid.

A

The correct answer is: b. Polypeptide.

152
Q

What are the main adverse effects of exenatide similar to pramlintide?
a. Rash and itching.
b. Nausea, vomiting, and diarrhea.
c. Headache and dizziness.
d. Weight gain and edema.

A

The correct answer is: b. Nausea, vomiting, and diarrhea.

153
Q

Which class of drugs does canagliflozin belong to?
a. DPP-IV inhibitors.
b. SGLT2 inhibitors.
c. GLP-1 receptor agonists.
d. Sulfonylureas.

A

The correct answer is: b. SGLT2 inhibitors.

154
Q

Which of the following drugs is an SGLT2 inhibitor along with canagliflozin?
a. Glipizide.
b. Metformin.
c. Dapagliflozin.
d. Sitagliptin.

A

The correct answer is: c. Dapagliflozin.

155
Q

What type of diabetes are SGLT2 inhibitors used to treat?
a. Type 1 diabetes.
b. Type 2 diabetes.
c. Gestational diabetes.
d. Prediabetes.

A

The correct answer is: b. Type 2 diabetes.

156
Q

What is the mechanism of action (MOA) of SGLT2 inhibitors?
a. They increase insulin secretion.
b. They inhibit glucose absorption in the intestines.
c. They inhibit the sodium-glucose cotransporter 2 (SGLT2) in the kidneys.
d. They stimulate insulin receptors.

A

The correct answer is: c. They inhibit the sodium-glucose cotransporter 2 (SGLT2) in the kidneys.

157
Q

What is the role of the sodium-glucose cotransporter 2 (SGLT2) in the kidneys?
a. It is responsible for secreting glucose.
b. It is responsible for reabsorbing filtered glucose.
c. It is responsible for producing insulin.
d. It is responsible for breaking down carbohydrates.

A

The correct answer is: b. It is responsible for reabsorbing filtered glucose.

158
Q

How do SGLT2 inhibitors affect blood glucose levels?
a. They increase blood glucose levels.
b. They have no effect on blood glucose levels.
c. They lower blood glucose levels.
d. They stabilize blood glucose levels.

A

The correct answer is: c. They lower blood glucose levels.

159
Q

How does the inhibition of SGLT2 affect sodium reabsorption and blood pressure?
a. Increases sodium reabsorption and raises blood pressure.
b. Decreases sodium reabsorption and reduces systolic blood pressure.
c. Has no effect on sodium reabsorption or blood pressure.
d. Increases sodium reabsorption and reduces blood pressure.

A

The correct answer is: b. Decreases sodium reabsorption and reduces systolic blood pressure.

160
Q

Are SGLT2 inhibitors indicated for the treatment of hypertension?
a. Yes, they are primarily used for hypertension.
b. No, they are not indicated for hypertension.
c. Yes, but only in combination with other antihypertensive drugs.
d. No, but they can be used off-label for hypertension.

A

The correct answer is: b. No, they are not indicated for hypertension.

161
Q

What are the most common adverse effects of SGLT2 inhibitors?
a. Nausea and vomiting.
b. Female genital mycotic infections and urinary tract infections.
c. Hypoglycemia and weight gain.
d. Dizziness and headaches.

A

The correct answer is: b. Female genital mycotic infections and urinary tract infections.

162
Q

Which specific condition is associated with female genital mycotic infections due to SGLT2 inhibitors?
a. Cystitis.
b. Vulvovaginal candidiasis.
c. Pyelonephritis.
d. Bacterial vaginosis.

A

The correct answer is: b. Vulvovaginal candidiasis.

Final Revision (9 decks)

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