Endocrine Pharmacology USMLE Step 1 Practice Question
A 74-year-old man with type 2 diabetes mellitus, severe peripheral vascular disease, and stage 4 chronic kidney disease (eGFR 18 mL/min/1.73m²) presents for medication adjustment. Vital signs: BP 142/88 mmHg, HR 76/min, RR 14/min, temperature 37.2°C. Recent labs show serum creatinine 3.2 mg/dL and bicarbonate 22 mEq/L. He denies chest pain or dyspnea. Which medication should be avoided due to increased lactic acidosis risk in advanced renal failure?
Answer choices
- ASitagliptin
- BAcarbose
- CRepaglinide
- DMetforminCorrect answer
- EGlipizide
- FPioglitazone
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