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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

  1. A patient with T2DM and stage 4 CKD (eGFR 22 mL/min) needs improved glycemic control. Which agent is safest to initiate?

    Answer: Insulin glargine

    Insulin glargine is safe in advanced CKD as it is not renally cleared; dose adjustments based on glucose monitoring are required.

  2. Which cardiovascular outcome trial for a GLP-1 receptor agonist demonstrated the largest relative risk reduction in MACE among T2DM patients with established CVD?

    Answer: SUSTAIN-6 (semaglutide)

    SUSTAIN-6 demonstrated a 26% relative risk reduction in MACE for semaglutide, one of the largest effects seen in GLP-1 RA cardiovascular outcome trials.

  3. A hypertensive patient with T2DM and bilateral renal artery stenosis requires blood pressure control. Which agent should be AVOIDED?

    Answer: Lisinopril

    ACE inhibitors are contraindicated in bilateral renal artery stenosis because they can precipitate acute kidney injury by reducing glomerular filtration pressure.

  4. Which combination of antidiabetic agents poses the HIGHEST risk of hypoglycemia?

    Answer: Sulfonylurea + basal insulin

    Combining a sulfonylurea with basal insulin significantly increases hypoglycemia risk because both agents independently stimulate insulin-mediated glucose lowering.

  5. A patient on amiodarone for atrial fibrillation starts on simvastatin 40 mg. What is the most appropriate recommendation?

    Answer: Limit simvastatin dose to 20 mg daily

    The FDA recommends limiting simvastatin to 20 mg/day when used with amiodarone due to increased myopathy risk from CYP3A4 inhibition.

  6. In an MTM consultation, a patient with T2DM reports taking ibuprofen daily for arthritis pain. What is the primary concern related to their cardiovascular medications?

    Answer: NSAIDs can raise blood pressure and blunt the effect of antihypertensives

    NSAIDs cause sodium retention and vasoconstriction, which can raise blood pressure and reduce the efficacy of antihypertensive medications.

  7. Which of the following is an absolute contraindication to the use of GLP-1 receptor agonists?

    Answer: Personal or family history of medullary thyroid carcinoma

    GLP-1 receptor agonists carry a black box warning and are contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN2.