Diabetes & Cardiovascular Pharmacotherapy Flashcards
7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Diabetes & Cardiovascular Pharmacotherapy flashcards as text
A patient with T2DM and CKD stage 3b (eGFR 32 mL/min) is on metformin 1000 mg BID. What is the most appropriate action?
Answer: Discontinue metformin due to increased lactic acidosis risk
Metformin is contraindicated when eGFR falls below 30 mL/min/1.73 m² and should be discontinued at eGFR <30 due to lactic acidosis risk.
Which SGLT2 inhibitor is FDA-approved specifically to reduce the risk of hospitalization for heart failure in patients with T2DM and established cardiovascular disease?
Answer: Empagliflozin
Empagliflozin (EMPA-REG OUTCOME trial) was first to demonstrate CV death and HF hospitalization reduction, earning that specific FDA indication.
A patient with newly diagnosed T2DM has an A1C of 8.4% and no cardiovascular or renal disease. Which agent is most appropriate as add-on to metformin according to ADA guidelines?
Answer: Sulfonylurea or other glucose-lowering agent based on patient factors
Without compelling CV or renal indications, ADA guidelines recommend selecting add-on therapy based on patient-specific factors like weight, cost, and hypoglycemia risk.
A pharmacist reviewing a patient's regimen notices they are on glipizide and clarithromycin. What interaction is most concerning?
Answer: Enhanced hypoglycemic effect due to CYP2C9 inhibition
Clarithromycin inhibits CYP3A4 and may also potentiate sulfonylurea effects, increasing hypoglycemia risk.
Which antihypertensive class is considered first-line for patients with T2DM and microalbuminuria?
Answer: ACE inhibitors or ARBs
ACE inhibitors and ARBs provide renoprotective benefits by reducing intraglomerular pressure and are first-line for diabetic patients with albuminuria.
A patient with T2DM, obesity, and HbA1c of 9.1% requests a medication that promotes weight loss. Which agent would be most appropriate?
Answer: Semaglutide
Semaglutide (GLP-1 RA) provides significant weight loss alongside glucose lowering and is preferred in obese T2DM patients.
Which of the following best describes the primary mechanism by which GLP-1 receptor agonists reduce cardiovascular events?
Answer: Direct anti-atherosclerotic and anti-inflammatory effects on vessel walls
GLP-1 RAs reduce CV events primarily through pleiotropic anti-atherosclerotic and anti-inflammatory mechanisms beyond glucose lowering.