Thiazolidinediones

Question 1

List.

Answer 1

• Pioglitazone (Actos)

- Rosiglitazone (Avandia)

Question 2

Dose ranges?

Answer 2

Pioglitazone (Actos):
- 15-45mg d

Rosiglitazone (Avandia):
4-8mg d

Question 3

MOA?

Answer 3

• decreases hepatic glucose production

- enhances glucose uptake (increase the sensitivity of peripheral tissues to insulin)

Question 4

Indication?

Answer 4

Type 2 diabetes
- alone or with metformin or a sulfonylurea
(ineffective in up to 30% of patients)

Question 5

Class?

Answer 5

Thiazolidinediones

Question 6

AEs?

Answer 6

• weight gain, peripheral oedema and fluid retention
  [should not be used in patients with heart failure or in combination with insulin (insulin = rosi, and pio =mod-severe HF)]
• headache, dizziness
• arthralgia/myalgia
• fractures
• increases in HDL and LDL cholesterol (rosi ie. Avandia)

Rare

• cardiac ischaemic events
• elevated liver enzymes

Question 7

Monitoring?

Answer 7

> heart function
Monitor for signs and symptoms of hepatic dysfunction:
- nausea with or without vomiting
- abdominal pain
- dark urine, and yellowing of the skin or eyes
falls especially in the elderly (bc fracture an ADR)
hepatic function

Question 8

Counseling?

Answer 8

• If you develop unexplained shortness of breath
  during daily activities, swollen ankles or increasing fatigue, seek medical advice.
• Do not take more than one aspirin tablet or capsule each day while being treated with this medicine.

Question 9

Label?

Answer 9

10a

- Do not take more than one aspirin tablet or capsule each day while being treated with this medicine.