Thiazolidinediones (TZD) DI

Question 1

TZDs primary MoA

Answer 1

Increase peripheral muscle glucose sensitivity

Question 2

TZDs secondary MoA

Answer 2

Decrease glucose output from liver

Question 3

TZD drugs

Answer 3

Pioglitazone (Actos), rosiglitazone (Avandia)

Question 4

Brand name of pioglitazone

Answer 4

Actos

Question 5

Brand name of rosiglitazone

Answer 5

Avandia

Question 6

Pioglitazone dosing

Answer 6

15-30mg PO QD, MDD 45mg

Question 7

Rosiglitazone dosing

Answer 7

4-8mg PO QD, MDD 8mg

Question 8

Side effects of TZDs

Answer 8

edema, weight gain, hepatotoxicity

Question 9

Pioglitazone specific side effects

Answer 9

Bladder cancer and fractures

Question 10

BBW for rosiglitazone

Answer 10

CHF and MI

Question 11

TZD CIs

Answer 11

NYHA Class III-IV, symptomatic CHF, ACS, active bladder cancer

Question 12

Precautions of TZDs

Answer 12

NYHA Class I-II, women, MI for rosiglitazone

Question 13

Counseling points for TZDs

Answer 13

Take once daily at the same time each day, ask about weight gain

Question 14

TZD pearls

Answer 14

Lowers A1C by 1%, pioglitazone has potential ASCVD benefit but both increase HF risk, neutral on CKD.

Question 15

Renal dosing for TZD

Answer 15

Not required

Question 16

TZD monitoring

Answer 16

FBG/PPG, A1C, LFTs, edema, weight gain, cholesterol panel

Question 17

TZD peak effect

Answer 17

6-8 weeks

Question 18

TZDs in ADA guidelines

Answer 18

used to minimize hypoglycemia or if cost is a major issue

Question 19

TZDs in AACE guidelines

Answer 19

not first-line