Oneliner_2098

OneLiner

A Patient, who has an exacerbation of chronic obstructive pulmonary disease (COPD), is receiving a macrolide antibiotic (azithromycin), a β-agonist (albuterol), an anticholinergic agent (ipratropium), and a corticosteroid (prednisone). His lab test results reveal hyperglycemia (normal random glucose level should be <200 mg/dL), which is likely related to the use of prednisone. Steroids cause hyperglycemia by promoting gluconeogenesis. Of the reactions listed, the conversion of oxaloacetate to phosphoenolpyruvate is the only one involved in gluconeogenesis. The conversion of oxaloacetate to phosphoenolpyruvate is catalyzed by phosphoenolpyruvate (PEP) carboxykinase, which functions as a regulatory enzyme in the gluconeogenesis pathway. PEP carboxykinase requires GTP and is an irreversible enzyme in gluconeogenesis.