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Sodium Glucose Cotransporter 2 (SGLT2) Inhibitors--Their role in the kidneys.

1. How many people in Canada are currently living with diabetes?

a) 11 million

b) 3.4 million

c) 1.2 million

d) 6 million

2. Canagliflozin, dapagliflozin and empagliflozin inhibit which transporter?

a) Sodium glucose cotransporter 1

b) Sodium glucose cotransporter 2

c) Sodium glucose antiport

d) Sodium ion channels

3. Which of the following regarding mechanisms of action of SGLT2 inhibitors is FALSE?

a) Main site of action is in the proximal renal tubules

b) Decreases reabsorption of sodium and glucose

c) Lowers the renal threshold for glucose

d) Decreases insulin resistance

4. Which of the following is NOT a contraindication for SLGT2 inhibitor use in patients with chronic kidney disease?

a) CrCl > 60 ml/min

b) CrCl > 45 ml/min

c) CrCl > 30 ml/min

d) Dialysis

5. A patient with an eGFR of 48 ml/min is currently taking empagliflozin 25 mg daily. The patient asks if this medicine is okay to take given his worsening renal function. What is the appropriate management strategy for empagliflozin in this case?

a) Decrease to 10 mg daily

b) Continue on 25 mg daily and monitor renal function

c) Hold empagliflozin until his eGFR returns to > 60 ml/min

d) Discontinue empagliflozin

6. Which agent had a pivotal trial that showed cardiovascular and renal outcomes with SGLT2 inhibitors?

a) Canagliflozin

b) Dapagliflozin

c) Empagliflozin

d) Gliflozin

7. What is the main postulated mechanism for renoprotective benefits with SGLT2 inhibitors?

a) Improved glycemic control

b) Reduction in hemoglobin A1C

c) Erythropoiesis

d) Hemodynamic effects

8. Which of the following is NOT a possible mechanism of renoprotection with SGLT2 inhibitors?

a) Natriuresis

b) Decrease in uric acid levels

c) Glycolysis

d) Improved glycemic control

9. Which of the following is NOT an adverse effect of SLGT2 inhibitors?

a) Hypoglycemia

b) Urinary tract infections

c) Hypotension

d) Hyperkalemia

10. Which of the following is true in the analysis of renally-impaired patients taking empagliflozin?

a) Slower progression of renal disease

b) Increased rates of renal events

c) Doubling of serum creatinine

d) Increase in serious adverse effects

By Brittani Prete, BSP, and Marisa Battistella, PharmD, ACPR

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Author:Prete, Brittani; Battistella, Marisa
Publication:CANNT Journal
Date:Jul 1, 2017
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