Pharmacy PEBC Practice Exam

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WW is a 55 year old, obese male (BMI 35) with newly diagnosed type 2 diabetes. His most recent fasting blood glucose is 9.6 mmol/L and A1C is 8%. He also suffers from hypertension and osteoarthritis in his knees. His current medications are: ramipril 20 mg po daily and acetaminophen 500 mg po qid. Which of the following agents is the most appropriate choice for WW at this time?

  1. Gliclazide

  2. Sitagliptin

  3. Canagliflozin

  4. Metformin

The correct answer is: Metformin

Metformin is the most appropriate choice for WW at this time. Metformin is a first-line treatment for type 2 diabetes, and it is recommended for patients with type 2 diabetes who are overweight or obese. Metformin can help to improve blood glucose control and can also lead to weight loss. This is important for WW because he is obese and has a high BMI. Additionally, since WW also suffers from hypertension, metformin may be a better choice than other medications that can increase blood pressure. It is also generally well-tolerated and has few side effects compared to other diabetes medications. Gliclazide is a sulfonylurea medication that can cause weight gain and may increase the risk of hypoglycemia, which could be dangerous for WW. Sitagliptin is a DPP-4 inhibitor that can increase the risk of joint pain,

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