Thiazolidinediones (TZDs)

Endocrine & Metabolic

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Examples

pioglitazonerosiglitazone

Prefix / Suffix: -glitazone

Physiology

Insulin resistance in muscle, fat, and liver tissue contributes to hyperglycemia in type 2 diabetes.

Mechanism of Action

Activate PPAR-gamma receptors, increasing insulin sensitivity in peripheral tissues and reducing hepatic glucose production.

Indications

Type 2 diabetes (add-on therapy)

Side Effects / Adverse Effects

Fluid retention, edema
Heart failure exacerbation (black box warning)
Weight gain
Increased fracture risk (especially in women)
Hepatotoxicity
Bladder cancer risk (pioglitazone — controversial)

Contraindications

Heart failure (NYHA Class III/IV)
Active liver disease
Bladder cancer (pioglitazone)

Nursing Considerations

Monitor for signs of heart failure: weight gain, edema, dyspnea
Daily weights — report rapid gain
Monitor LFTs at baseline and periodically
Effects take weeks to months — encourage adherence
Educate about fall and fracture prevention
Does not cause hypoglycemia as monotherapy

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.