Thiazolidinediones

Question 1

What is the most commonly used thiazolidinedione?

Answer 1

Pioglitazone.

Question 2

What is the mechanism of action of the thiazolidinediones?

Answer 2

Reduces insulin resistance in the liver and peripheral tissues, therefore reducing glucose in the blood.

Question 3

The incidence of heart failure is increased when pioglitazone is combined with which other anti-diabetic drug?

Answer 3

Metformin.

Question 4

Thiazolidinediones are linked with a small increase in which form of cancer?

Answer 4

Bladder cancer. Benefit normally outweighs the risk. Patients should be assessed for risk factors - uninvestigated macroscopic haematuria, age, smoking, exposure to chemo.

Question 5

What are the side effects of the thiazolidinediones?

Answer 5

GI upset, weight gain, oedema, hypoglycemia, anemia, headaches, visual disturbances, arthralgia, hematuria, impotence, liver toxicity.

Question 6

What specific monitoring is required for patients on thiazolidinediones?

Answer 6

Monitoring for heart failure. Patients should be able to recognize the signs and symptoms.

Question 7

What signs and symptoms of bladder cancer should patients on thiazolidinediones be aware of?

Answer 7

Hematuria, dysuria, urinary urgency.

Question 8

What signs and symptoms of liver toxicity should patients on thiazolidinediones be aware of?

Answer 8

Nausea, vomiting, abdominal pain, fatigue, dark urine.

Question 9

Risk of heart failure increases when patients use pioglitazone with which other anti-diabetic drug?

Answer 9

Metformin.