NAPLEX Question of the Week: Diabetes

One of the most common disease states encountered by pharmacists is diabetes and hence will be an important area to study for the NAPLEX.

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JU is a 42 year old female who reports to the pharmacotherapy clinic for follow up of her diabetes mellitus. She is currently on metformin 1g BID and has been tolerating well for about six months. A hemoglobin A1c obtained a week ago was 8.9%. The plan is to initiate liraglutide therapy in addition to the metformin. 

  1. Which of the following statements is true with regards to liraglutide?

A. The brand name of liraglutide is Bydureon. 

B. Nausea and/or vomiting are common side effects of therapy.

C. Liraglutide may be stored in the refrigerator or freezer prior to first use.

D. It should be administered intramuscularly into the upper arm. 

Answer with rationale:

The correct answer is B. Liraglutide is the GLP-1 agonist that decreases risk of cardiovascular events in patients with DM and established CAD. Therefore it is often the next drug used in management of DM after metformin. If you go and look at any drug information resource for any drug, nausea and/or vomiting will almost always be listed as it can happen with any drug! However some drugs are more problematic than others for significant nausea/vomiting.  A high number of patients will report initial nausea/vomiting with liraglutide therapy (or any GLP-1 agonist). Fortunately this tends to wane with subsequent doses and patients are able to tolerate long term. Answer A is incorrect as the brand name for liraglutide is Victoza. Additionally, a different liraglutide product used for weight loss is called Saxenda. The difference between the two products is dosing as Victoza is dosed 1.8 mg daily while Saxenda is 3mg daily. Answer C is incorrect as Victoza should only be stored in the refrigerator. Answer D is incorrect as while it may be administered in the upper arm, it should be given subcutaneously. It may also be given SQ in the abdomen or thigh. 

Christopher M. Bland

Clinical Professor, University of Georgia College of Pharmacy

Dr. Christopher M. Bland is a Clinical Professor at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has over 20 years of academic and clinical experience in a number of clinical areas. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy. He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with over 80 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as Editor-In-Chief for the Question of the Week. He has provided live, interactive reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.