Various Oral Antidiabetics
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Sulfonylureas | Glipizie (Glucotrol) Glimepiride (Amaryl)
Stimulate pancreas to produce more insulin
S/E: Weight gain, HYPOGLYCEMIA, Nausea, Heart Burn, Sulf Allergy, Drug/Drug Interaction: NSAIDs, Warfarin, Sulfonamides
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Nursing Implications for Sulfonylureas | Monitor for Hypoglycemia, give with breakfast, instruct patient to take at the same time daily, avoid use of ETOH, may be used in combination with other drugs.
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Alpha Glucosidase Inhibitors | Acarbose (Precose)
"Starch Blocker"- Slows down digestion of complex carbohydrates in intestines
S/E: Gas, Bloating, HYPOGLYCEMIA
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Nursing Implications for Alpha Glucosidase Inhibitors | Take with first bite of food, Monitor AST and ALT (Liver Functions)
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Biguanides "Anti-hyperglycemics" | Metformin (Glucophage)
Increase cell sensitivity to insulin and decreases hepatic glucose production and decreases intestinal absorption of glucose
S/E- Anorexia, N/V/D, Decreased absorption of Vit B12 and Folic Acid
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Nursing Implications for Biguanides | Give with meals.
XR with supper.
Must be stopped 48 prior and post anytime of study using contrast media (i.e. CT scans, angiography.)
Monitor BUN and Creatinine.
Avoid use in patients with HF, COPD, and Advanced Age
Avoid ETOH use
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Thiazolidinediones/Glitazones | Proglitazone (Actos)
Decreases Insulin Resistance
S/E- Upper Resp. Infection, Fluid Retention, Edema, Muslce Soreness, fatiuge, weight gain, headache, anemia, may cause liver failure
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Nursing Implications for Thiazolidinediones | Increases serum HDL and decreases Triglycerides
May be taken with or without food
Assess liver function (AST and ALT)
Instruct women who are using birth control to use another form.
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Meglitinides | Nateglinide (Starlix) Repaglinide (Prandin)
Stimulate Insulin production in the pancreas.
S/E Hypoglycemia, Nausea, Weight gain
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Nursing Implications for Meglitinides | Take 30 mins before meals, 2-4 times a day
Avoid use of ETOH
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Dipeptidyl Peptidase-4 (DPP-4) Inhibitor | Stigliptin (Januvia)
Increases and prolongs the action of incretin( Incretin acts on beta cells in the pancrease to increase insulin production)
S/E- Upper Resp. Infection, Stuffy/Runny nose, Sore Throat, Diarrhea, Stomach discomfort
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Nursing Implications for DPP-4 Inhibitors | Admin once a day
Monitor Renal Function (BUN, Creatinine)
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