Medical Pharmacology: Diabetes Management Practice
Questions
Click on the correct answer.
Member(s) of the biguanide oral hypoglycemic drug class currently in use:
Phenformin
Buformin
Metformin
A & B
B & C
A & C
A, B & C
Possible mechanism(s) of metformin-mediated hypoglycemic effect.
Reduction in gluconeogenesis
AMP-dependent protein kinase (AMPK) activation.
Both
Neither
Therapeutic effects due to metformin administration likely derives from increased AMP-activated protein kinase which decreases lipogenesis and hepatic gluconeogenesis.
True
False
Metformin:
First-line treatment for patients with type II diabetes
May be used as monotherapy
May be used in combination with other oral hypoglycemic drugs or insulin for management of type II diabetes.
A & B
B & C
A & C
A, B & C
Metformin in addition to be effective in treating type II diabetes is also helpful in managing type I diabetes.
True
False
Metformin:
Appropriate to start metformin at diagnosis (type II diabetes)
Metformin administration tends to improve
both fasting and postprandial hyperglycemia.
Both
Neither
Metformin administration in obese patients with diabetes improves hypertriglyceridemia
but without the weight gain typically associated with sulfonylurea-type drugs or insulin.
True
False
Metformin pharmacokinetics and complications:
Half-life is about one day (18-24 hours)
Metformin, by reducing liver lactic acid metabolism, may in patients with renal insufficiency, increase the possibility of lactic acidosis.
Both
Neither
In addition to decreasing hepatic glucose hepatic production, metformin also decreases glucose absorption by the intestines.
True
False
Metformin:
Onset of action is likely within days.
Maximal metformin effects may take up to a couple of weeks.
Both
Neither
Metformin is metabolized principally by the liver.
True
False
A principal concern with metformin administration is weight gain in most patients.
True
False
Most common side effects associated with metformin administration are related to the gastrointestinal tract.
True
False
Severe kidney dysfunction (eGFR <30/ml/minute/1.73m2) is considered a contraindication to metformin treatment.
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Source Material:
Powers A D'Alessio D Chapters 47:
Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and
Hypoglycemia in Goodman & Gilman's: The Pharmcological
Basis of Therapeutics, 13e, (Brunto LL Hilal-Dandan R Knollmann
BC, eds) McGraw-Hill Education, 2018.
Masharani U Diabetes
Mellitus (27-01) in Current Medical Diagnosis & Treatment (Papadakis
MA McPhee SJ Rabow MW McQuaid KR, eds) 61e McGraw Hill 2022.
Masharani U Kroon L
Chapter 41: Pancreatic Hormones & Glucose-Lowering Drugs
in Basic & Clinical Pharmacology (Katzung BG, Editor; Vanderah
TW, Associate editor) 15e McGraw Hill 2021.
