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 on insulin detemir develops recurrent fasting hyperglycemia despite titration. The pharmacist suspects dawn phenomenon. Which adjustment is most appropriate?
Answer: Administer insulin detemir at bedtime instead of morning
Administering basal insulin at bedtime targets the overnight rise in glucose from the dawn phenomenon more effectively than morning dosing.
Which of the following medications used in heart failure has been shown to improve glycemic control in patients with T2DM by reducing insulin resistance?
Answer: Carvedilol
Carvedilol, unlike other beta-blockers, has alpha-1 blocking activity that may improve insulin sensitivity and is considered metabolically favorable.
A pharmacist performing an MTM review notices a patient with T2DM and dyslipidemia is on niacin. Which concern should be raised regarding niacin use in this population?
Answer: All of the above
Niacin worsens insulin resistance, fails to reduce CV outcomes (AIM-HIGH), and raises fasting glucose, making it poorly suited for patients with T2DM.
A patient with T2DM and atrial fibrillation is on apixaban for stroke prevention. They ask about taking aspirin for heart protection. What is the best counseling response?
Answer: Adding aspirin to apixaban significantly increases bleeding risk without additional CV benefit in most patients
Dual antithrombotic therapy (DOAC + aspirin) substantially increases major bleeding risk and is not recommended unless the patient has a specific indication such as recent ACS.
Which blood pressure target is recommended for most patients with T2DM and hypertension according to the 2023 ADA Standards of Care?
Answer: Less than 130/80 mmHg
ADA recommends a BP target of less than 130/80 mmHg for most patients with diabetes and hypertension to reduce CV and renal risk.
A patient with T2DM and a recent myocardial infarction is started on a high-intensity statin. Six weeks later, labs show markedly elevated creatine kinase with muscle pain. What is the most appropriate action?
Answer: Discontinue the statin immediately and evaluate for rhabdomyolysis
Significantly elevated CK with myalgia raises concern for rhabdomyolysis, requiring immediate statin discontinuation and renal function monitoring.
Which of the following best describes the mechanism by which SGLT2 inhibitors reduce hospitalizations for heart failure?
Answer: They reduce preload and afterload through osmotic diuresis and natriuresis
SGLT2 inhibitors reduce cardiac preload and afterload primarily through glucosuria-driven osmotic diuresis and sodium excretion, independent of glycemic effects.