Biguanides Quiz

1. Metformin is one of the diabetes medications that can cause a hypoglycaemic event (a blood glucose level under 4mmol/L that should be treated with refined sugar).

A) True

B) False

Correct! Wrong!

2. Consideration should be given for ceasing metformin temporarily in the following:

A) If a person is dehydrated

B) If a person needs to have surgery

C) If a person is having a procedure involving contrast dye

D) All the above

Correct! Wrong!

3. Mrs Smith has been newly diagnosed with type 2 diabetes and recently started on metformin XR 1000mg two tablets daily. As the pharmacist you have time to interact and give her some advice. Which best describes the scenario that is most likely to help Mrs Smith in this situation?

A) Do nothing-this is not your role as the pharmacist today.

B) Make sure Mrs Smith knows how to take the metformin and what to look out for with respect to side effects.

C) Log into Pharmacy Diabetes and navigate to Diabetes Interventions/Medication Interventions/Biguanides to help guide you how best to support Mrs Smith. Document any interventions and diabetes services delivered using the Electronic Intervention Log.

D) Refer her to the internet for information.

Correct! Wrong!

4. Mr Jones has been on metformin 500mg three times a day with food for approximately 5 years. Lately he has started to notice every time he eats out, he has an upset stomach the next day. He has come to you to ask your advice. How do you best address this enquiry?

A) Given your knowledge of how metformin can cause intermittent diarrhoea, you suspect this might be the cause of Mr Jones’ stomach discomfort. This is despite the many years he has been taking metformin. You use a Diabetes Medscheck to give him education and advice and refer him back to his health care professional with a letter suggesting a change to metformin XR.

B) Suggest he ask his GP for a referral to see a gastroenterologist to check for irritable bowel syndrome.

C) Suggest Mr Jones stop eating out.

D) Suggest a probiotic.

Correct! Wrong!

5. Metformin is one of the medicines that is often still prescribed when insulin is commenced to keep the dose of insulin as low as possible.

A) True

B) False

Correct! Wrong!

6. The following are true about metformin tablets

A) Taken with or soon after food

B) Never crushed

C) Excreted unchanged in the urine

D) All of above

Correct! Wrong!

7. Mr Crane has been a loyal customer of your pharmacy for many years. He was diagnosed with type 2 diabetes many years ago and explains he used to regularly monitor his glucose levels when first diagnosed, however his levels never seemed to change that much and so he stopped monitoring. He now relies “on the level the GP measures every three months”. Lately he has been feeling run down, sleeping more, feeling hungry and feels he has lost some weight without intending to. He has also developed sores on his legs that will not heal. Given your knowledge about Mr Crane and his diabetes what would the most appropriate step be for Mr Crane?

A) Encourage him to see his GP as soon as possible even though you know this wait could be up to one month for a non-urgent appointment.

B) Log in to Pharmacy Diabetes for resources that will be helpful for Mr Crane. Determine if Mr Crane is eligible for a Diabetes MedsCheck. Ask Mr Crane about blood glucose monitoring again during this appointment and see to it that he able to do this again with the appropriate in date equipment. Refer to appropriate allied health professionals for screening and refer to his GP with the extra information that monitoring will provide the GP. Reassure Mr Crane that his diabetes is possibly progressing and that you will help him get the care he needs by referring him to the appropriate health care providers. Log all interventions.

C) Tell Mr Crane not to worry. After all he is getting older and at his age, he must expect that he will begin to slow down a little!

D) Tell Mr Crane to start blood glucose monitoring again.

Correct! Wrong!

8. The treatment for all types of diabetes is healthy eating, physical activity, stress management, and, if appropriate medication.

A) True

B) False

Correct! Wrong!

Biguanides Quiz

1. Metformin is one of the diabetes medications that can cause a hypoglycaemic event (a blood glucose level under 4mmol/L that should be treated with refined sugar).

2. Consideration should be given for ceasing metformin temporarily in the following:

3. Mrs Smith has been newly diagnosed with type 2 diabetes and recently started on metformin XR 1000mg two tablets daily. As the pharmacist you have time to interact and give her some advice. Which best describes the scenario that is most likely to help Mrs Smith in this situation?

4. Mr Jones has been on metformin 500mg three times a day with food for approximately 5 years. Lately he has started to notice every time he eats out, he has an upset stomach the next day. He has come to you to ask your advice. How do you best address this enquiry?

5. Metformin is one of the medicines that is often still prescribed when insulin is commenced to keep the dose of insulin as low as possible.

6. The following are true about metformin tablets

8. The treatment for all types of diabetes is healthy eating, physical activity, stress management, and, if appropriate medication.

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