Which hormone released by the Islets of Langerhans, acts to increase blood glucose?

A. The patient may choke: This is not the primary concern for extended-release medications like metformin (Glucophage XL). While choking is a risk with any pill, it's not specific to the need for avoiding crushing or chewing extended-release formulations.
B. It would cause blood glucose levels to rise too rapidly: Crushing or chewing the medication would not cause blood glucose levels to rise rapidly. Instead, it could lead to a more rapid release and absorption of the drug, which might lower blood glucose too quickly, potentially leading to hypoglycemia.
C. Irritation of the oral mucosa may occur: While irritation of the oral mucosa could be a concern with some medications, it is not the primary reason for avoiding the crushing or chewing of extended-release formulations like Glucophage XL.
D. The effect of the medication may be changed: Crushing or chewing an extended-release tablet disrupts its formulation. Glucophage XL is designed to release metformin slowly over time. If the tablet is crushed or chewed, it can result in the entire dose being released at once, which can alter the intended pharmacokinetics and pharmacodynamics of the drug. This could lead to a higher risk of side effects and a loss of the extended-release benefit, ultimately changing the medication's effect and possibly leading to issues like hypoglycemia or gastrointestinal side effects.

A. "Have you noticed any blood in your stool?" While this could be a symptom of a severe reaction, it's not the most immediate concern for an allergic reaction.
B. "Are you having difficulty with your hearing?" Hearing problems are not typical symptoms of an antibiotic allergy.
C. "Do you have a headache?" Headaches can occur with various conditions, including allergic reactions, but it's not the most concerning symptom in this case.
D. "Are you having any difficulty breathing?" Difficulty breathing can be a sign of a severe allergic reaction (anaphylaxis) and requires immediate intervention. This is the most critical symptom to assess for.