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Diabetes Meds
Oral Antidiabetics
| Question | Answer |
|---|---|
| Sulfonylureas | Glipizide |
| Sulfonylureas: Action | Stimulates the release of insulin |
| Sulfonylureas: Side/Adverse Effects | -mild hypoglycemia can occur in patients with impaired liver or kidney function -nausea/diarrhea -dermatologic reactions |
| Sulfonylureas: Contraindications/Interactions | -lactation -DKA -alcohol poses risk for disulfiram or antabuse like reaction -alcohol & beta-blockers increase risk for hypoglycemia |
| Sulfonylureas: Nursing Considerations/Interventions | -monitor s/s of hypoglycemia -only use if patient still has some pancreas beta-cell function -take with food if GI upset occurs -take once a day, 30 mins before breakfast |
| Meglitinides | Repaglinide |
| Meglitinides: Action | stimulates release of insulin from islet cells of functioning pancreas |
| Meglitinides: Side/Adverse Effects | -hypoglycemia -GI disturbances -URIs -back pain -headache |
| Meglitinides: Contraindications/Interactions | -DKA -hypoglycemic effects increase with: -Gemfibrozil -Erythromycin -Ketoconazole -Grape fruit juice -Ginseng - Garlic |
| Meglitinides: Nursing Considerations/Interventions | -should not be taken if meal is skipped -amount given related to blood glucose level |
| Biguanide | Metformin |
| Biguanide: Action | Lowers blood glucose in three ways: 1) decrease absorption of glucose from intestines 2) decrease synthesis of glucose by the liver 3) increase sensitivity of insulin receptors in tissues |
| Biguanide: Side/Adverse Effects | -nausea/diarrhea -anorexia -vitamin deficiencies -lactic acidosis -abdominal discomfort |
| Biguanide: Contraindications/Interactions | -DKA -cardiopulmonary, hepatic or renal insufficiency -alcoholism -lactic acidosis -furosemide |
| Biguanide: Nursing Considerations/Interventions | -monitor for weakness, fatigue, lethargy, hyperventilation -no effect on pancreatic beta-cell function -do not give with alpha-glucodiase inhibitors |
| Thiazolidinediones | Pioglitazone |
| Thiazolidinediones: Actions | reduce insulin resistance of tissue (insulin must be available for this to happen); inhibits gluconeogenisis |
| Thiazolidinediones: Side/Adverse Effects | -fluid retention -hepatotoxicity -increased serum lipid levels |
| Thiazolidinediones: Contraindications/Interactions | -cardiovascular disease -HTN -heart failure -active hepatic disease |
| Thiazolidinediones:Nursing Considerations/Interventions | -regularly scheduled liver-function tests -monitor for edema, weight gain, shortness of breath or indications of heart failure -hepatotoxicity |
| Alpha glucosidase inhibitors | Acarbose |
| Alpha glucosidase inhibitors: Action | enzyme that breaks down carbs in the intestine; reduces sudden rise in blood sugar after meals |
| Alpha glucosidase inhibitors: Side/Adverse Effects | -hypoglycemia -GI effects -liver dysfunction -anemia |
| Alpha glucosidase inhibitors: Contraindications/Interactions | -obstruction -ulceration -insulin sulfonylureas -estrogens -thiazides -corticosteroids |
| Alpha glucosidase inhibitors: Nursing Considerations/Interventions | -must be taken immediately before a meal -prepare to treat hypoglycemia with 4g Dextrose not Glucose -recommend iron rich foods and supplements |
| Gliptins | Sitagliptin |
| Gliptins: Action | augments naturally occurring incretin hormones by inhibiting the enzyme that inactivates them; promotes release of insulin; decrease secretion of glucagon; lowers fasting and postprandial blood glucose |
| Gliptins: Side/Adverse Effects | -upper respiratory infection -headache -pancreatitis -hypoglycemia |
| Gliptins: Contraindications/Interactions | -Type 1 diabetes -lactic acidosis -sitagliptin may increase Digoxin levels |
| Gliptins: Nursing Considerations/Interventions | -monitor for respiratory symptoms, temperature and breath sounds |
| Amylin mimetics | Pramlintide |
| Amylin mimetics: Action | mimics actions of naturally occurring peptide hormone produced by pancreas; slows gastric emptying; inhibit secretions of glucagon |
| Amylin mimetics: Side/Adverse Effects | -hypoglycemia (severe when combined with insulin) -nausea |
| Amylin mimetics: Contraindications/Interactions | -renal failure -hemodialysis -poor insulin regimen -A1C above 9 -slows absorption of oral drugs |
| Amylin mimetics: Nursing Considerations/Interventions | -recommend reduced insulin dosage with use |
| Incretin mimetics | Exenatide |
| Incretin mimetics: Action | synthetic peptide (GLP-1) similar to glucagon; activates GLP-1 receptors after meal; slows gastric emptying; stimulate release of insulin in the presence of glucose |
| Incretin mimetics: Side/Adverse Effects | -hypoglycemia -n/v/d -pancreatitis |
| Incretin mimetics: Contraindications/Interactions | -renal failure -DKA -Type 1 diabetes -ulcerative colitis |
| Incretin mimetics: Nursing Considerations/Interventions | -monitor for persistent n/v/d -monitor patient's ability to maintain fluid and carb intake -monitor for s/s of pancreatitis |
| Hyperglycemic agent | Glucagon |
| Hyperglycemic agent: Action | increases blood glucose by increasing breakdown of glycogen into glucose |
| Hyperglycemic agent: Side/Adverse Effects | -GI distress -HTN -bronchospasm -dizziness |
| Hyperglycemic agent: Nursing Considerations/Interventions | -may repeat in 15 min if needed -IV glucose must be given if patient fails to respond -cannot correct hypoglycemia d/t starvation -can be administered IV, IM or subQ |
Created by:
NikkiLeigh83
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