MTM Diabetes & Cardiovascular Pharmacotherapy 4

Question 1

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

Accepted Answer

Insulin glargine

Answer

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

Question 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?

Accepted Answer

SUSTAIN-6 (semaglutide)

Answer

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.

Question 3

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

Accepted Answer

Lisinopril

Answer

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

Question 4

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

Accepted Answer

Sulfonylurea + basal insulin

Answer

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

Question 5

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

Accepted Answer

Limit simvastatin dose to 20 mg daily

Answer

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

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Diabetes & Cardiovascular Pharmacotherapy 4