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    Pharmacology proctored exam (examplify)

    A patient with type 2 diabetes mellitus has a prescription for a change in oral antidiabetic agents from glipizide to acarbose. The patient asks the nurse why there is no need to be worried about the new drug causing hypoglycemia. What is the nurse's best answer?

    Explanation & Rationale

    A. Because your pancreatic function is improving, it does not need as much stimulation, so acarbose is not as powerful as glipizide: Acarbose does not work by influencing pancreatic function. Instead, its action occurs in the gastrointestinal tract, where it delays carbohydrate absorption. B. Glipizide is a sulfonylurea that increases insulin secretion regardless of blood glucose, which can cause hypoglycemia. Acarbose is an alpha-glucosidase inhibitor that slows carbohydrate breakdown and absorption, lowering postprandial glucose without increasing insulin secretion, making hypoglycemia less likely. C. Acarbose does not enhance glucose uptake by cells. Its action is limited to slowing carbohydrate digestion and absorption in the intestines, so this explanation does not correctly describe its mechanism. D. Glipizide is not an oral insulin; it is a sulfonylurea that stimulates insulin release. Acarbose does not suppress glucagon secretion but acts locally in the gut to reduce carbohydrate absorption.

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