Anesthesia Pharmacology Chapter 29 Diabetes Management Practice Questions

Exendin-4:
1. Reptilian peptide (extracted from Gila monster venom)
2. About 50% sequence identical to GLP-1
3. Both
4. Neither
Extendin-4: this peptide is a glucagon-like peptide 1 receptor agonist that exhibits both pharmacological and physiological actions similar to GLP-1.
1. True
2. False
Exendin-4:
1. Is not a substrate for dipeptidyl peptidase 4
2. Exhibits longer-term pharmacological activity after injection.
3. True
4. False
Exenatide (Byetta and others) is a synthetic exendin-4 molecule that has been approved for use both as monotherapy and along with other agents for type II diabetes management.
1. True
2. False
Using exenatide as monotherapy or in combination with metformin, thiozolidinedione or sulfonylurea was associated with:
1. Better glycemic control
2. Weight gain
3. Both
4. Neither
Exenatide may be used in combination with basal insulin.
1. True
2. False
Exenatide pharmacokinetics:
1. Half-life: about 2.5 hours
2. Glucose-reducing action is about 6 hours.
3. Both
4. Neither
Exenatide administration is not appropriate for patients with eGFR <30 ml/min/1.73m².
1. True
2. False
Exenatide and the immune system.
1. Exenatide administration may induce relatively low level antibodies (against exenatide) and about 40% of patients. This effect is not impact clinical activity.
2. Some patients (about 5%) may exhibit high-tighter antibodies following exenatide. about half of these patients may exhibit decreasing glycemic response to exenatide.
3. Both
4. Neither
Half-life of administration for exenatide:
1. Immediate release daily formulation: about 2.5 hours
2. Extended release formulation (weekly administration): about 2 weeks
3. Both
4. Neither
Most of administered dose of exenatide is metabolized by the liver cytochrome P450 drug metabolizing system.
1. True
2. False
Incidence of adverse reaction occurring >10%:
1. Gastrointestinal
2. Immunologic
3. Injection site reactions
4. A & B
5. B & C
6. A & C
7. A, B & C