Antidiabetic drugs: pioglitazone: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antidiabetic drugs: pioglitazone

Sample item

A 64-year-old man with type 2 diabetes has weight gain, bilateral ankle swelling and exertional dyspnoea a few weeks after a new oral drug is added. Which drug is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Pioglitazone

Thiazolidinediones activate PPAR-gamma, improving insulin sensitivity, but also promote renal sodium and water retention, causing oedema and precipitating heart failure. They are contraindicated in New York Heart Association class III and IV failure. Other adverse effects include weight gain and fractures.

Option by option

  • A. Sitagliptin

    Sitagliptin is weight-neutral and is not associated with oedema from fluid retention.

  • B. Acarbose

    Acarbose causes flatulence and diarrhoea and no fluid retention.

  • C. Pioglitazone (correct)

    Correct. PPAR-gamma activation causes fluid retention and can precipitate heart failure.

  • D. Gliclazide

    Gliclazide mainly causes hypoglycaemia and modest weight gain, not marked fluid retention.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Pioglitazone. Thiazolidinediones activate PPAR-gamma, improving insulin sensitivity, but also promote renal sodium and water retention, causing oedema and precipitating heart failure.

Why is "Sitagliptin" not the answer?

Sitagliptin is weight-neutral and is not associated with oedema from fluid retention.

Why is "Acarbose" not the answer?

Acarbose causes flatulence and diarrhoea and no fluid retention.

Why is "Gliclazide" not the answer?

Gliclazide mainly causes hypoglycaemia and modest weight gain, not marked fluid retention.

What concept does this question test?

It tests Antidiabetic drugs: pioglitazone in Pharmacology. They are contraindicated in New York Heart Association class III and IV failure. Other adverse effects include weight gain and fractures.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidiabetic drugs: pioglitazone?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.