Patient is prescribed a gliptin for his type 2 diabetes. You are to educate this patient on what class this medication is and what it does. All of the following are correct except:

A. Bile-acid sequestrants, such as colesevelam, primarily lower serum cholesterol levels. While they may have a modest effect on glucose levels, they do not directly improve insulin sensitivityor significantly reduce hepatic glucose production, which are the main mechanisms of pioglitazone.

B. Thiazolidinediones (TZDs), including pioglitazone (Actos)and rosiglitazone, are oral hypoglycemic agentsused for type 2 diabetes mellitus. They work by activating peroxisome proliferator-activated receptor gamma (PPAR-γ) receptorsin adipose, muscle, and liver tissue. This leads to enhanced insulin sensitivity, improved glucose uptake in peripheral tissues, and modest reduction in hepatic glucose production. TZDs are used as adjuncts to diet and exerciseto improve glycemic control. They are usually well tolerated, with common side effects including upper respiratory tract infection, headache, sinusitis, and myalgia. However, nurses should monitor for weight gain, fluid retention, edema, and signs of heart failure, which are rare but serious adverse effects.

C. Alpha-glucosidase inhibitors(e.g., acarbose, miglitol) work by slowing carbohydrate absorptionin the small intestine to reduce postprandial hyperglycemia. They do not improve insulin sensitivityor reduce hepatic glucose production, so they are mechanistically different from TZDs.

D. Non-insulin injectable drugs, such as GLP-1 receptor agonists (e.g., liraglutide, dulaglutide), are injectable agentsthat enhance glucose-dependent insulin secretion, slow gastric emptying, and promote satiety. Pioglitazone is an oral agent, not an injectable.

A. Topical anesthetics are applied directly to the skin or mucous membranes (via spray, cream, gel, or ointment) to desensitize a localized area. They work by blocking nerve endingsat the surface, reducing pain for minor procedures such as IV insertion, suturing, or minor dermatologic procedures.

B. This involves injecting anesthetic near a nerve or group of nervesto block sensation in a larger region of the body, such as an arm or leg. It is more invasive than a topical spray and is used for surgical procedures requiring regional anesthesia.

C. In this type, the anesthetic is injected directly into the tissuearound a surgical site to numb a small area. Unlike topical anesthesia, it involves needle injection and is not simply applied to the surface.

D. General anesthesia induces a loss of consciousness and systemic analgesia, usually through inhalation agents or IV medications. Topical sprays are not systemicand do not cause unconsciousness, so this is not applicable.