Review Question - QID 100408

Weight gain, edema (fluid retention), edema, and heart failure are toxicities associated with pioglitazone. The drug should not be administered to patients with heart failure.

Pioglitazone and rosiglitazone are thiazolidinedione derivatives that reduce insulin resistance in patients with DM2. They are occasionally used as monotherapy for DM2 but are most often combined with other hypoglycemics. The drugs are also used to treat polycystic ovarian syndrome.

Incorrect Answers:
Answer 1: Glargine is a long-acting insulin analog. Like other insulin analogs, toxicities include hypoglycemia and rare hypersensitivity reactions.
Answer 2: Glipizide is a second-generation sulfonylurea used to stimulate release of endogenous insulin in DM2. Toxicities include hypoglycemia and weight gain. It is metabolized by the liver and should be used with caution in those with liver disease.
Answer 3: Metformin, a biguanide, is the first line therapy for patients with DM2. Toxicities include lactic acidosis; the drug is contraindicated in patients with renal failure.
Answer 5: Pramlintide is an amylin mimetic used as an insulin-adjunct in diabetes mellitus types 1 and 2 to decrease glucagon secretion and slow gastric emptying. Toxicities include hypoglycemia, nausea, and diarrhea