Question

Scenario 2: JF, a 63-year-old AAM, recently started Bydureon 2 mg once weekly for control of his type 2 diabetes mellitus in addition to metformin 1 g PO BID. The resident physician is concerned about JF's kidney function and tells you JF's most recent SCris 1.5 mg/dL. 4. Based on JF's SCr, what is his eGFR today in mL/min/1.73 m?? You will enter your answer rounded to the nearest whole number in Examsoft - no units. Fill in the blank eGFR: 57 5. Based on JF's SCr, how would you mange JF's metformin? a. Discontinue metformin b. Decrease dose to 500 mg PO BID C. Decrease dose to 1 g PO daily d. Continue current dose and monitor frequently 6. Based on today's SCr, how would you manage JF's Bydureon? Select the best option. a. Discontinue Bydureon b. Continue Bydureon at current dose C. Discontinue Bydureon and initiate Adlyxin 10 mcg SubQ daily for 14 days and titrate appropriately d. Decrease dose of Bydureon to 1 mg once weekly

Answer 1

5, a, continue current dose and monitor frequently
Stopping metformin results in poorly controlled glycemia and cause adverse reactions. Metformin to be stopped if serum creatinine exceeds more than 1.7mg/dl or falls below 30ml/min. renal failure is a risk factor for adverse effects with metformin use. patient serum creatinine level 1.5mg/dl should be continued with the current dose with regular monitoring of renal function every 3-6months.
6, b, continue Bydureon at the current dose
Bydureon is not recommended if GFR is less than 45. Patient GFR is 57 can be continued with the same dose Bydureon but caution should be done for monitoring renal function if the patient complains of GI effects.