What is the action of the Sitagliptin?

Appeared in: DSSSB 6 September 2024

Explanation

Sitagliptin is classified as an oral antidiabetic agent used for the management of Type 2 Diabetes Mellitus.
It belongs to the drug class of dipeptidyl peptidase-4 (DPP-4) inhibitors.
Its mechanism involves inhibiting the DPP-4 enzyme, which prevents the breakdown of incretin hormones (GLP-1 and GIP).
This action increases glucose-dependent insulin secretion from the pancreas and reduces glucagon release from the liver, thereby lowering blood glucose levels.

Option A: This is incorrect. Cardiac glycosides, such as digoxin, act on the heart muscle to increase contractility and are used for heart failure.
Option B: This is incorrect. Antihypertensives are a class of drugs used to lower blood pressure. Sitagliptin's primary effect is on glucose metabolism.
Option D: This is incorrect. Antiarrhythmic drugs are used to treat irregular heart rhythms by altering the electrical conduction in the heart.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification and action of Sitagliptin as background academic context rather than a clinical decision trigger.
Nurses must monitor patients on Sitagliptin for signs and symptoms of pancreatitis (e.g., severe and persistent abdominal pain, which may radiate to the back), as this is a rare but serious adverse effect.
Since Sitagliptin is primarily excreted by the kidneys, it is crucial to monitor renal function (e.g., serum creatinine, eGFR). Dose adjustments are necessary for patients with moderate to severe renal impairment.
Patient education should include the importance of adherence to diet and exercise, how to recognize and manage hypoglycemia (especially if taken with other antidiabetic agents like sulfonylureas), and when to report adverse effects to the healthcare provider.

How to Approach the Question

First, identify the drug name in the question: 'Sitagliptin'.
This is a pharmacology question that requires recalling the drug's therapeutic class and primary use.
Recognize the suffix '-gliptin', which is characteristic of the DPP-4 inhibitor class of drugs.
Recall that DPP-4 inhibitors are oral medications used to treat Type 2 Diabetes.
Scan the options to find the one that matches this therapeutic use.
Select 'Antidiabetic' as it directly corresponds to the drug's function. The other options relate to cardiovascular conditions and are therefore incorrect.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 322-324

E6 Pharmacology Nursing Lilley 11e Part 2 p. 208-210

Practise the full DSSSB 6 September 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.