Anurse is caring for a client who has diabetes mellitus and is taking pioglitazone. the nurse should plan to monitor the client for which of the following adverse effects?
a. tinnitus
b. insomnia
c. fluid retention
d. orthostatic hypotension



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2 .dont brake your diet
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C. Fluid Retention


Pioglitazone belongs to the family of Thiazolidinediones, they act as ligands of the PPARgamma receptor, a pair of nuclear hormone receptors that participate in the regulation of genes related to the metabolism of glucose and lipids. They are used for patients with DM2, specially those with renal disease, since they do not metabolize in the kidney. Among their therapeutical effects they increase secretion of adiponectine, lower liver fat and redistributes it to the subcutaneal layer of the skin. Their side effects include:

-Hepatotoxicity with increased liver enzymes

- Increase risk of long-term fractures

-Weight gain, due to fluid retention with edema. The edema is formed by intracellular effects by the stimulation of Na + pumps which stimulates the hydrosaline retention.

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