Medication Management Flashcards

A patient is prescribed empagliflozin (Jardiance) and develops painful urination with white discharge. What is the most likely adverse effect?

Answer: Genital mycotic infection due to glucosuria

SGLT2 inhibitors increase urinary glucose excretion, creating an environment that promotes genital mycotic (yeast) infections, especially in women.

Which insulin analogue has the longest duration of action among the following options?

Answer: Insulin glargine U-300 (Toujeo)

Insulin glargine U-300 (Toujeo) has the longest duration of action at up to 36 hours, longer than standard glargine U-100, NPH, or detemir.

A patient taking sitagliptin (Januvia) reports severe, persistent abdominal pain radiating to the back. What complication should be immediately suspected?

Answer: Acute pancreatitis

DPP-4 inhibitors including sitagliptin have been associated with acute pancreatitis; severe abdominal pain radiating to the back is a classic presentation.

Which statement about pramlintide (Symlin) is correct?

Answer: It is a synthetic amylin analogue that slows gastric emptying and suppresses glucagon

Pramlintide is a synthetic analogue of amylin that mimics its effects: slowing gastric emptying, suppressing postprandial glucagon, and promoting satiety.

When educating a patient about taking acarbose (Precose), which instruction is most important?

Answer: Take it with the first bite of each main meal

Acarbose must be taken with the first bite of each meal because it works by competitively inhibiting alpha-glucosidase enzymes in the small intestine during carbohydrate digestion.

A patient on basal-bolus insulin therapy has consistently elevated fasting blood glucose values. Which adjustment is most appropriate?

Answer: Increase the basal insulin dose

Consistently elevated fasting glucose indicates insufficient basal insulin coverage overnight; the basal (long-acting) insulin dose should be increased.

Which cardiovascular benefit is uniquely associated with SGLT2 inhibitors compared to other diabetes drug classes?

Answer: Significant reduction in hospitalization for heart failure

SGLT2 inhibitors have demonstrated consistent, robust reduction in heart failure hospitalizations in multiple cardiovascular outcomes trials, a benefit not seen with other glucose-lowering drug classes.