Nokea
Which of the following antidiabetic agents acts on the peroxisome proliferator-activated receptor-gamma (PPAR-gamma) nuclear receptor?
- A. acarbose
- B. glyburide
- C. insulin lispro
- D. pioglitazone
Correct Answer: D
Rationale: Pioglitazone is a thiazolidinedione that activates PPAR-gamma, enhancing insulin sensitivity in peripheral tissues.
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A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia.
Drug of choice in phenothiazine induced parkinsonism is
- A. Levodopa
- B. Haloperidol
- C. Metoclopramide
- D. None of the above
Correct Answer: A
Rationale: Levodopa counters phenothiazine-induced parkinsonism.
What is the interaction of pheno barbiton and warfarin
- A. Displacement of warfarin from binding site
- B. Decreased absorption of warfarin
- C. Increased metabolism of warfarin
- D. Decreased metabolism of warfarin
Correct Answer: C
Rationale: Phenobarbitone induces liver enzymes, increasing warfarin metabolism.
Not metabolized in liver
- A. Cimetidine
- B. Phenytoin
- C. Diazepam
- D. Penicillin G
Correct Answer: D
Rationale: Penicillin G is primarily excreted unchanged by the kidneys, unlike the others metabolized by the liver.
Research has shown that when patients who are covered by Medicare Part D reach the 'donut hole' in coverage they:
- A. Ask for extra refills of medication to get them through the months of no coverage
- B. Fill their prescriptions less frequently, including critical medications such as warfarin or a statin
- C. Fill their critical medications, but hold off on filling less-critical medications
- D. Demonstrate no change in their prescription filling pattern
Correct Answer: B
Rationale: Patients reduce prescription filling, even for critical drugs, during the donut hole.