antidiabetics

Question 1

Metformin (Glucophage) MOA

Question 2

Metformin (Glucophage) indications

Answer 2

type 2 and gestational diabetes

Question 3

Metformin (Glucophage) AE

Answer 3

GI- n/v/ decreased appetite
toxicity- lactic acidosis
decreased B12 and folic acid absorption

Question 4

Metformin (Glucophage) NC

Answer 4

-educate on lactic acid s/s
-monitor renal impairment
-stop for elective contrast CT on hospital admission
-B12 and folic acid supplements
-potential for weight loss

Question 5

Glipizide- Sulfonylurea MOA

Answer 5

stimulates pancreatic insulin release

Question 6

Glipizide- Sulfonylurea indications

Answer 6

type 2 diabetes

Question 7

Glipizide- Sulfonylurea AE

Answer 7

hypoglycemia: likely with kidney/live dysfunction
very rare: SJS/TENS/CV toxicity

Question 8

Glipizide- Sulfonylurea NC

Answer 8

edu and monitor hypoglycemia s/s
contraindicated during pregnancy and breastfeeding
avoid alcohol
concurrent use wit BB can diminish sulfa benefits

Question 9

Pioglitazone MOA

Answer 9

turns on insulin-responsive genes that are responsible for carb and lipid metabolism

Question 10

Pioglitazone indication

Answer 10

type 2 diabetets only

Question 11

Pioglitazone AE

Answer 11

fluid retention
ovulation in premenopausal women
increased risk of fractures in women
bladder cancer

Question 12

Pioglitazone NC

Answer 12

educate and monitor for heart failure s/s
assess GU hx and ROS
interactions w/ CYP2C8 inhibitors

Question 13

Acarbose MOA

Answer 13

delays absorption of carbs

Question 14

Acarbose indication

Answer 14

type 2 diabetes

Question 15

Acarbose AE

Answer 15

GI-related
Liver dysfunction with long-term high-dose tx
Anemia due to decreased absorption of Fe

Question 16

Acarbose NC

Answer 16

If used with insulin or sulfonylurea, hypoglycemia treatment with glucose only
Monitor LFT and s/s liver dysfunction

Question 17

Canagliflozin MOA

Answer 17

stimulates glucose-dependent release of insulin and suppresses release of glucagon

Question 18

Canagliflozin indication

Answer 18

type 2 diabetes

Question 19

Canagliflozin AE

Answer 19

Female GU fungal infections & UTI
Postural hypotension and dizziness in older adults
Very rarely, lower limb amputation

Question 20

Canagliflozin NC

Answer 20

Educate on GU infections
Fall precautions, especially in those with concurrent diuretic use
Monitor for new pain, soreness, sores, ulcers, and infections in legs and feet

Question 21

Sitagliptin MOA

Answer 21

stimulates glucose-dependent release of insulin

Question 22

Sitagliptin indication

Answer 22

type 2 usually used with metformin

Question 23

Sitagliptin AE

Answer 23

Generally well tolerated
Pancreatitis (fatal hemorrhagic or necrotizing) rare
Hypersensitivity, including SJS/TENS, angioedema, and anaphylaxis

Question 24

Sitagliptin NC

Answer 24

Educate & monitor on s/s of pancreatitis
Educate & monitor for rash and allergy

Question 25

Semaglutide MOA

Answer 25

slows gastric emptying, stimulates release of insulin, inhibits postprandial glucagon, and suppress appetite

Question 26

Semaglutide indications

Answer 26

Type II DM mono- or adjunct treatment as Ozempic (with CV benefits) Chronic weight management as Wegovy

Question 27

Semaglutide

Answer 27

N/V/D are most common Increased risk of pancreatitis and renal impairment/AKI Hypersensitivity reactions Possible MTC from animal studies

Question 28

Semaglutide NC

Answer 28

Educate & monitor on common s/s Educate on medication regimen Educate patient on different types of injectable medications

Question 29

Tirzepatide MOA

Question 30

Tirzepatide indications

Answer 30

type 2

Question 31

Tirzepatide AE

Answer 31

GI effects, including N/V/D, constipation, and abdominal pain Increased risk of pancreatitis and renal impairment/AKI Hypersensitivity reactions Possible MTC from animal studies

Question 32

Tirzepatide NC

Answer 32

Educate & monitor on common s/s Educate on medication regimen Educate patient on different types of injectable medications