Glitazones Quiz

1. The significant drop in prescribing of thiazolidinediones is due largely to:

A) Expense

B) They cause hypoglycaemia

C) Recent studies indicate there is a cardiovascular toxicity with rosiglitazone and an increase in bladder cancer with pioglitazone. The risk of prescribing needs to outweigh the risks of not prescribing.

D) It is difficult to spell the name of each medication.

Correct! Wrong!

2. Side effects of rosiglitazone include

A) Weight gain and oedema

B) Bone fractures

C) Hypercholesterolaemia

D) All the above

Correct! Wrong!

3. Mr Smith is a reasonably active 65-year-old man and is a regular customer to the pharmacy. He has had type 2 diabetes for many years and is taking insulin, injecting twice a day. He explains to you that he does not eat “all that much” and is doing his best to do regular physical activity because he knows how important this is for his diabetes management and overall health. He finds physical activity difficult because of arthritis in both hips and knees making even walking painful. He is somewhat frustrated because he is unable to stabilise his diabetes even having tried most of the medications for diabetes but has experienced significant side effects. The dispense history shows him having prescribed a DPP4 inhibitor, a SGLT2 inhibitor and metformin in the past. He has now been prescribed pioglitazone under the specialised care of an endocrinologist. He has started to put on weight and understands from reading the CMI he was given, this is a side effect of this new medication. He is also worried about the other side effects listed such as heart failure, bone fractures and cancer and advises his father died of a heart attack. What, if any of the scenarios below do you think is best for Mr Smith and his diabetes management?

A) Nothing. Mr Smith should continue to do what he is doing since he is under a specialist after all.

B) Acknowledge that Mr Smith has concerns and these concerns may impact on his decision as to whether he will continue to take his pioglitazone. After having a discussion with him you think it best he continues to take the pioglitazone since he has tried most other medications and they have not worked. Refer him back to the GP or endocrinologist if he has further questions.

C) Acknowledge that Mr Smith has concerns and these concerns may impact on his decision as to whether he will continue to take his pioglitazone. Refer him back to his GP to talk about his concerns.

D) Acknowledge Mr Smith concerns and how these concerns may impact his decision to continue with pioglitazone. Determine if Mr Smith is eligible for a Diabetes Medscheck. Refer to the appropriate allied health professionals for screening for side effects and refer to GP for annual cycle of care to alleviate Mr Smith’s concern about the medication. Log all interventions using the Electronic Intervention Log @ Pharmacy Diabetes.

Correct! Wrong!

Glitazones Quiz

1. The significant drop in prescribing of thiazolidinediones is due largely to:

2. Side effects of rosiglitazone include

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