MEDizzy - A 57-year-old obese man was diagnosed with type 2 diabetes

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Drugs for Diabetes Mellitus

A 57-year-old obese man was diagnosed with type 2 diabetes mellitus. The patient had been suffering from chronic obstructive pulmonary disease for 5 years and from hypertension for 3 years. His current therapy included ipratropium and captopril. Which of the following antidiabetic drugs would be relatively contraindicated in this patient?

ExplanationBiguanides can cause lactic acidosis and therefore are relatively contraindicated in all conditions that predispose to acidosis. This patient is suffering from chronic obstructive pulmonary disease and is under treatment with an angiotensin-converting enzyme (ACE) inhibitor. The respiratory disease predisposes to respiratory acidosis, and ACE inhibitors predispose to metabolic acidosis because they lower aldosterone serum levels.