Anesthesia Pharmacology Chapter 29 Diabetes Management Pracrtice Questions

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Member(s) of the biguanide oral hypoglycemic drug class currently in use:
1. Phenformin
2. Buformin
3. Metformin
4. A & B
5. B & C
6. A & C
7. A, B & C
Possible mechanism(s) of metformin-mediated hypoglycemic effect.
1. Reduction in gluconeogenesis
2. AMP-dependent protein kinase (AMPK) activation.
3. Both
4. Neither
Therapeutic effects due to metformin administration likely derives from increased AMP-activated protein kinase which decreases lipogenesis and hepatic gluconeogenesis.
1. True
2. False
Metformin:
1. First-line treatment for patients with type II diabetes
2. May be used as monotherapy
3. May be used in combination with other oral hypoglycemic drugs or insulin for management of type II diabetes.
4. A & B
5. B & C
6. A & C
7. A, B & C
Metformin in addition to be effective in treating type II diabetes is also helpful in managing type I diabetes.
1. True
2. False
Metformin:
1. Appropriate to start metformin at diagnosis (type II diabetes)
2. Metformin administration tends to improve both fasting and postprandial hyperglycemia.
3. Both
4. Neither
Metformin administration in obese patients with diabetes improves hypertriglyceridemia but without the weight gain typically associated with sulfonylurea-type drugs or insulin.
1. True
2. False
Metformin pharmacokinetics and complications:
1. Half-life is about one day (18-24 hours)
2. Metformin, by reducing liver lactic acid metabolism, may in patients with renal insufficiency, increase the possibility of lactic acidosis.
3. Both
4. Neither
In addition to decreasing hepatic glucose hepatic production, metformin also decreases glucose absorption by the intestines.
1. True
2. False
Metformin:
1. Onset of action is likely within days.
2. Maximal metformin effects may take up to a couple of weeks.
3. Both
4. Neither
Metformin is metabolized principally by the liver.
1. True
2. False
A principal concern with metformin administration is weight gain in most patients.
1. True
2. False
Most common side effects associated with metformin administration are related to the gastrointestinal tract.
1. True
2. False
Severe kidney dysfunction (eGFR <30/ml/minute/1.73m²) is considered a contraindication to metformin treatment.
1. True
2. False