QUESTION: 65

Which of the following class of antidiabetic medication may cause fluid retention?

Bile acid sequestrant
GLP-1 agonist
Thiazolidinediones
SGLT2 Inhibitor
Alpha-glucosidase inhibitor

Answer(s): C

Explanation:

Thiazolidinediones may cause fluid retention through proposed mechanism of increasing reabsorption in the collecting duct of the kidney and increasing vascular permeability in adipose tissue. Bile acid sequestrants work in the intestine to bind bile acids which doesn’t affect fluid retention. GLP-1 receptor agonists work to activate these receptors to secrete insulin from beta pancreatic cells/decrease glucagon secretion/ increase satiety and doesn’t affect fluid retention. SGLT2 inhibitors actually cause increase of fluid elimination through the kidneys. Alpha-glucosidase inhibitors work in the gut to decrease carb absorption/digestion and have no affect on fluid retention.

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QUESTION: 66

Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?

Lisinopril
Furosemide
Naproxen
Amiodarone
Warfarin

Answer(s): C

Explanation:

ACE-inhibitors (such as lisinopril), NSAIDs (such as naproxen) and loop diuretics (furosemide) can all increase the risk of lithium toxicity.

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QUESTION: 67

Which of the following class of antidiabetic medications can increase triglycerides?

Bile acid sequestrant
GLP-1 agonist
Thiazolidinediones
SGLT2 Inhibitor
Alpha-glucosidase inhibitors

Answer(s): A

Explanation:

The only bile acid sequestrant, colesevelam (Welchol), has been shown to increase triglycerides through mechanism of: activation of phosphatidic acid phosphatase with promotes triglyceride synthesis. GLP-1 agonists work on GLP 1 receptors to increase insulin secretion, decrease glucagon secretion, and increase satiety. Thiazolidinediones activate nuclear transcription factor PPAR gamma to increase insulin sensitivity. SGLT2 inhibitors inhibit glucose reabsorption in the kidney. Alpha- glucosidase inhibitors slow down digestion and absorptions of carbs in the gut.

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QUESTION: 68

A Physician orders Dobutamine HCl IV infusion at 5 mcg/kg/min. Dobutamine HCl is available as 500 mg in 250 mL of D5W. The patient weighs 68 kg. Calculate the infusion rate in mL/hr.

10.2mls/hr
5.2mls/hr
0.17mls/hr
22.4mls/hr
340mls/hr

Answer(s): A

Explanation:

68 kg × [5 mcg/kg/min] = 340 mcg/min Bag concentration = 2 mg/ml or 2000 mcg/ml 340 mcg × [1 mL/2000 mcg] = 0.17 mL/min 60 in × [0.17 mL/min] = 10.2 mLs in one hour

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