QuestionSBA
QuestionChoice
Weight gain is recognised as a common or very common side effect of pioglitazone due to fluid retention although the exact mechanism underlying this process is not known
34200
a
Pioglitazone 30mg PO daily
QuestionChoice
Cholecalciferol does not commonly cause weight gain
34203
d
Cholecalciferol 400U PO daily
QuestionChoice
Ramipril does not commonly cause weight gain
34204
e
Ramipril 2.5mg PO daily
QuestionChoice
Atorvastatin does not commonly cause weight gain
34202
c
Atorvastatin 20mg PO daily
QuestionChoice
Amlodipine does not commonly cause weight gain
34201
b
Amlodipine 10mg PO daily
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2783
Pioglitazone side effects
Topic
9
Internal Medicine
6851
Case Presentation: A 65-year-old man attended his GP for the results of his blood test. PMH Type 2 diabetes mellitus, Hypercholesterolemia, Hypertension. DH Atorvastatin 20mg PO daily, Pioglitazone 30mg PO daily, Amlodipine 10mg PO daily, Cholecalciferol 400U OD, Ramipril 2.5mg PO OD.


**On Examination**

BP 135/80mmHg, HR 85, RR 14, Weight 65kg (63kg 4 months ago)

**Investigation**

Total cholesterol 150 mg/dL (100-200), LDL 50mg/dL (0-99), HDL 100mg/dL (39-150)

Question: After ruling out poor diet and lack of exercise, select the prescription that is most likely to contribute to his weight gain.
a