Question 2.2 A 60 yo woman recently diagnosed with type 2 DM (she has h/o HTN be

Question

Question 2.2 A 60 yo woman recently diagnosed with type 2 DM (she has h/o HTN being treated with hydrochlorothiazide (HCTZ)) presents to you for recommendations for initial pharmacologic therapy. She is 5-foot-4 and weighs 110 lbs; SCr is 1.0 mg/dL and LFTs are moderately elevated. Most of the choices below are therapeutic options. However, at this point and time, excluding differences in extraglycemic benefits, she may be an IDEAL CANDIDATE for therapy with

       Biguanide

       Glitazone

       Gliptin

       Sulfonylurea

After oral DM therapy has begun, which of the following parameters will most likely be checked? (Points : 2)

       Hemoglobin A1C

       Serum albumin

       Lipid panel

       Self-monitoring glucose stick

Based on current data and recommendations for cardiovascular disease, DM and HTN, she may also THEORETICALLY benefit from...

Check all that apply.

        Clopidogrel (Plavix)

        Aspirin

        ACE-inhibitor

        Beta blocker

        Statin

Explanation / Answer

Q2).

a). Biguanide --> No clinically significant interaction occurs between metformin and HCTZ is reported and metformin is suitable for a wide range of DM-II candidates.

b). Glitazone --> Hydrochlorothiazide reduce the effect of glitazones (especially pioglitazone)

c). Gliptin -> Hydrochlorothiazide reduce the effect of gliptins

d). Sulfonylurea ---> Recommended or elderly obese patients

The patient has to be checked for Hemoglobin A1C, to assess the usefulness of metformin in this particular patient.

Further, she might get benefited from Statin therapy, which reduces the cholesterol levels (LDLs) and reduces the risk of stroke

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