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Antidiabetic Drugs Flashcards

(62 cards)

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0
Q

Glipizide (Glucotrol)

Chemical Classification

A

Sulfonylurea (2nd generation)

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1
Q

Glipizide (Glucotrol)

Functional Classification

A

Antidiabetic

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2
Q

Glipizide (Glucotrol)

Mechanism of Action

A

Causes functioning beta cells in pancreas to release insulin; leading to drop in blood glucose levels; may improve insulin binding to insulin receptors or increase the number of insulin receptors with prolonged administration; may also reduce basal hepatic glucose secretion; not effective if patient lacks functioning beta cells

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3
Q

Glipizide (Glucotrol)

Uses

A

Type 2 diabetes mellitus

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4
Q

Glipizide (Glucotrol)

Contraindications

A

Hypersensitivity to sulfonylureas, type 1 diabetes, diabetic ketoacidosis

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5
Q

Glipizide (Glucotrol)

Side Effects

A

CNS: Headache, Weakness, Dizziness, Drowsiness, tinnitus, fatigue, vertigo
ENDO: HYPOGLYCEMIA
GI: HEPATOTOXICITY, CHOLESTATIC JAUNDICE, nausea, vomiting diarrhea, heartburn
HEMA: LEUKOPENIA, THROMBOCYTOPENIA, AGRANULOCYTOSIS, APLASTIC ANEMIA; increased AST, ALT, alk phos; PANCYTOPENIA, HEMOLYTIC ANEMIA
INTEG: rash, allergic reactions, pruritus, urticaria, eczema, photosensitivity, erythema, allergic vasculitis

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6
Q

Glipizide (Glucotrol)

Nursing Considerations

A

ASSESS:

  • HYPO/HYPERGLYCEMIC REACTION that can occur soon after meals; for severe hypoglycemia give IV D50W, then IV dextrose solution
  • Blood Glucose, A1c levels during treatment to determine diabetes control
  • Blood Dyscrasias: CBC at baseline and throughout treatment; report decreased blood count
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7
Q

Glipizide (Glucotrol)

Overdose Treatment

A

Glucose 25g IV via dextrose 50% sol, 50ml, 1mg glucagon, or carbohydrate depending on severity

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8
Q

Human Insulin Lispro (Humalog)

Type

A

Rapid Acting

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9
Q

Human Insulin Lispro (Humalog)

Onset

A

0.5-1 hr

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10
Q

Human Insulin Lispro (Humalog)

Peak Action

A

2-4 hr

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11
Q

Human Insulin Lispro (Humalog)

Nursing Implications

A

Not to be given IV

Give within 15 min of a meal

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12
Q

Human Insulin Lispro (Humalog)

Insulin Overdose Treatment

A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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13
Q 
Insulin Aspart (NovoLog)
(Type)
A

Rapid Acting

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14
Q 
Insulin Aspart (NovoLog)
(Onset)
A

5 to 15 min

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15
Q 
Insulin Aspart (Novolog)
(Peak Action)
A

0.75 to 1.5 hr

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16
Q 
Insulin Aspart (NovoLog)
(Nursing Implications)
A

Not to be given IV

Give within 15 min of a meal

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17
Q 
Insulin Aspart (NovoLog)
(Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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19
Q 
Regular Insulin (Human)
(Type)
A

Short Acting

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20
Q 
Regular Insulin (Human)
(Peak Action)
A

2 to 3 hr

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21
Q 
Regular Insulin (Human)
(Nursing Implications)
A

Regular insulin may be given IV

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22
Q 
Regular Insulin (Human)
(Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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23
Q 
Regular Insulin (Human)
(Onset)
A

30 to 60 min

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24
Q 
Isophane insulin (NPH)
(Onset)
A

1 to 2 hr

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25
``` Isophane Insulin (NPH) (Peak Action) ```
6 to 12 hr
26
``` Isophane Insulin (NPH) (Nursing Implications) ```
Not to be given IV
27
``` Isophane Insulin (NPH) (Insulin Overdose Treatment) ```
Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg
28
``` Insulin Glargine (Lantus) (Type) ```
Long acting
29
``` Insuline Glargine (Lantus) (Onset) ```
1.1 hr
30
``` Insulin Glargine (Lantus) (Peak Action) ```
5hr (some sources say there is no peak)
31
``` Insulin Glargine (Lantus) (Nursing Implications) ```
Not to be given IV | Recommended to give once daily, acts as basal insulin
32
``` Insulin Glargine (Lantus) Insulin Overdose Treatment) ```
Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg
33
Metformin | Functional Classification
Antidiabetic, oral
34
Metformin | Chemical Classification
Biguanide
35
Metformin | Mechanism of Action
Inhibits hepatic glucose production and increases sensitivity of peripheral tissue to insulin
36
Metformin | Uses
Type 2 diabetes mellitus
37
Metformin | Contraindications
Hypersensitivity; hepatic disease; creatinine >1.5mg/ml (males), >/= 1.4 (females); alcoholism; cardiopulmonary disease; acidemia; acute MI; cardiogenic shock; diabetic ketoacidosis; metabolic acidosis
38
Metformin | Side Effects
CNS: Headache, Weakness, Dizziness, Drowsiness, tinnitus, fatigue, vertigo, Agitation CV: HEART FAILURE ENDO: LACTIC ACIDOSIS, hypoglycemia GI: Nausea, Vomiting, Diarrhea, heartburn, anorexia, metallic taste HEMA: THROMBOCYTOPENIA, decreased vit B12 levels INTEG: rash
39
Metformin | Nursing Considerations
ASSESS: - HYPOGLYCEMIC REACTIONS (sweating, weakness, dizziness, anxiety, tremors, hunger); hyperglycemic reactions soon after meals; these occur rarely with product, may occur when product combined with sulfonylureas - CBC (baseline, q3mo) during treatment check LFTs periodcially, AST, LDH, renal studies: BUN, creatinine during treatment; glucose, A1c; folic acid, vit B12 q1-2yr - LACTIC ACIDOSIS: malaise, myalgia, abdominal distress; risk increases with age, poor renal function; monitor electrolytes, lactate, pyruvate, blood pH, ketones, glucose PERFORM/PROVIDE: -Conversion from other oral hypoglycemic agents; change may be made without gradual dosage change; monitor serum glucose, urine ketones tid during conversion
40
Pioglitazone (Actos) | Functional Classification
Antidiabetic; oral
41
Pioglitazone (Actos) | Chemical Classification
Thiazolidinedione
42
Pioglitazone (Actos) | Mechanism of Action
Specifically targets insulin resistance; an insulin sensitizer; regulates the transcription of a number of insulin-responsive genes
43
Pioglitazone (Actos) | Uses
Type 2 diabetes mellitus
44
Pioglitazone (Actos) | Contraindications
Breastfeeding, children, hypersensitivity to thiazolidinedione, diabetic ketoacidosis, CHF
45
Pioglitazone (Actos) | Side Effects
CNS: Headache CV: MI, HEART FAILURE, DEATH (GERIATRIC PATIENTS) ENDO: hypo/hyperglycemia MISC: Sinusitis, Upper Respiratory Tract Infection, Pharyngitis, HEPATOTOXICITY, edema, weight gain, anemia, macular edema; RISK OF BLADDER CANCER (USE >1yr) MS: RHABDOMYOLYSIS
46
Pioglitazone (Actos) | Nursing Considerations
ASSESS: - For CHF: excessive/rapid weight gain >5lb, dyspnea, edema; may need to be reduced or discontinued - RHABDOMYOLYSIS: muscle pain, increased CPK, weakness, swelling of affected muscles; if these occur and if confirmed by CPK, product should be discontinued - HYPOGLYCEMIC REACTIONS: sweating, weakness, dizziness, anxiety, tremors, hunger; hyperglycemic reactions soon after meals (rare); do not give with NYHA class III/IV heart failure - Check LFT's periodically: AST, LDH; do not start treatment in active heart disease or if ALT>2.5x upper limit of normal; if treatment has already begun, follow closely with continuing ALT levels; if ALT increases to >3x upper limit of normal, recheck ALT as soon as possible; if ALT remains >3x upper limit of normal, discontinue - FBS, glycosylated HbA1c, plasma lipids/lipoproteins, BP, body weight during treatment - CBC with differential prior to and during therapy; more necessary in those with anemia PERFORM/PROVIDE: -Conversion from other oral hypoglycemic agents; change may be made with gradual dosage change; monitor serum glucose during conversion
47
Repaglinide | Functional Classification
Antidiabetic
48
Repaglinide | Chemical Classification
Meglitinide
49
Repaglinide | Mechanism of Action
Causes functioning beta-cells in pancreas to release insulin, thereby leading to a drop in blood glucose levels; closes ATP-dependent potassium channels in the beta-cell membrane; this leads to the opening of calcium channels; increased calcium influx induces insulin secretion
50
Repaglinide | Uses
Type 2 diabetes
51
Repaglinide | Contraindications
Hypersensitivity to meglitinides; diabetic ketoacidosis, type 1 diabetes
52
Repaglinide | Side Effects
CNS: Headache, Weakness, paresthesia ENDO: HYPOGLYCEMIA GI: nausea, vomiting, diarrhea, constipation, dyspepsia INTEG: rash, allergic reactions MISC: chest pain, UTI, allergy MS: back pains, arthralgia RESP: URI, sinusitis, rhinitis, bronchitis
53
Repaglinide | Nursing Considerations
ASSESS: -HYPO/HYPERGLYCEMIC REACTION, which can occur soon after meals: dizziness, weakness, headache, tremor, anxiety, tachycardia, hunger, sweating, abdominal pain, A1c, fasting, postprandial glucose during treatment
54
Repaglinide | Overdose Treatment
Glucose 25g IV via dextrose 50% solution, 50ml or 1mg glucagon
55
Sitagliptin | Functional Classification
Antidiabetic, oral
56
Sitagliptin | Chemical Classification
Dipeptidyl-peptidase-4 inhibitor (DPP-4 inhibitor)
57
Sitagliptin | Mechanism of Action
Slows the inactivation of incretin hormones; improves glucose homeostasis, improves glucose-dependent insulin secretion, lowers glucagon secretions, and slows gastric emptying time
58
Sitagliptin | Uses
Type 2 diabetes mellitus as monotherapy or in combination with other antidiabetic agents
59
Sitagliptin | Contraindications
Hypersensitivity, diabetic ketoacidosis (DKA)
60
Sitagliptin | Side Effects
CNS: Headache ENDO: hypoglycemia GI: Nausea, Vomiting, abdominal pain, diarrhea, PANCREATITIS, constipation MISC: Peripheral Edema SYST: ANAPHYLAXIS, STEVENS-JOHNSON SYNDROME, ANGIOEDEMA
61
Sitagliptin | Nursing Considerations
ASSESS: - HYPOGLYCEMIC REACTIONS: sweating, weakness, dizziness, anxiety, tremors, hunger; hyperglycemic reactions soon after meals - SERIOUS SKIN REACTIONS: swelling of face, mouth, lips, dyspnea, wheezing - PANCREATITIS: severe abdominal pain, nausea, vomiting; discontinue product - RENAL STUDIES: BUN, creatinine during treatment - Glycosylated hemoglobin A1c; monitor blood glucose (BG) as needed PERFORM/PROVIDE: -Conversion from other antidiabetic agents; change may be made with gradual dosage change
62
``` Isophane insulin (NPH) (Type) ```
Intermediate Acting

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