ATI Ch 37, Antidiabetic Agents Flashcards
(196 cards)
1
Q
What is the primary cause of Type 1 diabetes?
A
Genetic predisposition for beta cell destruction and environmental factors (viral)
Autoimmunity also plays a role in Type 1 diabetes.
2
Q
What happens to adipose and muscle cells in Type 2 diabetes?
A
They become less sensitive to the actions of insulin
Alternatively, the pancreas may produce less insulin than the body needs.
3
Q
What is a key characteristic of Type 2 diabetes?
A
Glucose levels in the blood escalate
This occurs due to insulin resistance or insufficient insulin production.
4
Q
What condition can develop during pregnancy related to glucose?
A
Gestational diabetes
This condition causes the woman to become intolerant to glucose.
5
Q
Fill in the blank: Type 1 diabetes is associated with _______.
A
genetic predisposition for beta cell destruction
6
Q
Fill in the blank: In Type 2 diabetes, the pancreas produces _______ insulin than the body needs.
A
less
7
Q
What is Type 1 diabetes?
A
An autoimmune condition where the immune system attacks insulin-producing beta cells in the pancreas.
8
Q
What causes sudden, unexplained weight loss in Type 1 diabetes?
A
The body breaks down fat and muscle for energy due to the inability to use glucose effectively.
9
Q
What is polyuria?
A
Frequent urination caused by high blood sugar levels overwhelming the kidneys.
10
Q
What leads to polydipsia in Type 1 diabetes?
A
Increased urination causes dehydration, triggering excessive thirst.
11
Q
Define polyphagia.
A
Feeling very hungry despite eating, due to the body’s inability to use glucose for energy.
12
Q
What symptom might indicate a lack of energy in Type 1 diabetes?
A
Feeling very weak or sleepy due to cells being deprived of glucose.
13
Q
How can bed-wetting be a symptom of Type 1 diabetes?
A
Excessive urination (polyuria) can lead to accidents, especially at night in previously toilet-trained children.
14
Q
What are nausea, vomiting, or abdominal pain indicative of in Type 1 diabetes?
A
Signs of diabetic ketoacidosis (DKA), a serious complication due to fat breakdown.
15
Q
List the 3 P’s associated with diabetes.
A
- Polyuria: Excessive urination
- Polydipsia: Excessive thirst
- Polyphagia: Excessive hunger
16
Q
How do the symptoms of Type 1 diabetes differ from Type 2 diabetes?
A
Both deal with the 3 P’s, but Type 1 symptoms appear suddenly and are more severe; Type 2 symptoms may develop slowly or be mild/asymptomatic.
Footnote##
Type 2 also does not feature weight loss.
17
Q
True or False: The 3 P’s are more pronounced in Type 2 diabetes.
A
False
18
Q
Fill in the blank: The body produces _______ due to fat breakdown in the absence of insulin.
A
ketones
19
Q
What does insulin resistance indicate about cell responsiveness?
A
Cells require higher-than-normal insulin levels to take up glucose effectively.
Insulin resistance means the cells are not completely unresponsive to insulin.
20
Q
How do insulin injections help overcome insulin resistance?
A
By increasing the amount of insulin in the bloodstream, providing the extra ‘push’ needed for glucose to enter the cells.
This allows for better glucose uptake despite the resistance.
21
Q
What are the direct effects of insulin injections on blood sugar levels?
A
They lower blood sugar levels by:
* Promoting glucose uptake in somewhat responsive cells
* Suppressing glucose production in the liver
* Reducing lipolysis
These actions help manage hyperglycemia in diabetes.
22
Q
What role does the liver play in hyperglycemia in diabetes?
A
The liver contributes to hyperglycemia by producing glucose.
Insulin injections suppress this glucose production.
23
Q
What effect do insulin injections have on lipolysis?
A
They reduce lipolysis, decreasing ketone production and preserving muscle mass.
This is important for metabolic health in individuals with diabetes.
24
Q
Which tissues retain partial sensitivity to insulin even in insulin resistance?
A
Muscle and fat tissues.
These tissues can still optimize glucose uptake when additional insulin is provided.
25
Fill in the blank: Insulin injections help by promoting glucose uptake in cells that are still somewhat _______.
responsive.
26
True or False: Insulin injections only work in completely sensitive cells.
False.
27
What is the Fasting Plasma Glucose (FPG) level that indicates diabetes?
≥ 126 mg/dL (7.0 mmol/L) after no caloric intake for at least 8 hours
## Footnote
This test evaluates baseline blood sugar levels.
28
What is the 2-Hour Plasma Glucose (OGTT) threshold for diagnosing diabetes?
≥ 200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT)
## Footnote
The test measures blood glucose 2 hours after drinking a glucose-rich solution.
29
What A1C level indicates diabetes?
≥ 6.5%
## Footnote
Reflects average blood glucose over the past 2-3 months and should be performed in a certified lab.
30
What is the random plasma glucose level that indicates diabetes?
≥ 200 mg/dL (11.1 mmol/L) in individuals with symptoms of hyperglycemia
## Footnote
Symptoms include polyuria, polydipsia, and unexplained weight loss.
31
What Fasting Plasma Glucose (FPG) range indicates prediabetes?
100–125 mg/dL (5.6–6.9 mmol/L)
## Footnote
This condition is known as impaired fasting glucose (IFG).
32
What is the 2-Hour Plasma Glucose (OGTT) range for prediabetes?
140–199 mg/dL (7.8–11.0 mmol/L)
## Footnote
This condition is known as impaired glucose tolerance (IGT).
33
What A1C level indicates prediabetes?
5.7–6.4%
## Footnote
Indicates higher-than-normal glucose levels but not high enough for diabetes diagnosis.
34
True or False: Diagnosis of diabetes can be confirmed with just one test result that meets the criteria.
False
## Footnote
Diagnosis is confirmed if one of the tests meets the criteria on two separate occasions or if there are symptoms with matching lab results.
35
Why is screening for diabetes important?
It is crucial for at-risk populations
## Footnote
At-risk factors include obesity, family history, or ethnic predisposition.
36
The diabetic type II framework emphasizes the synergistic effect of optimizing three physical behaviors throughout the day:
• Reducing sedentary behavior (sitting less).
• Incorporating regular movement and exercise.
• Prioritizing quality sleep.
37
What is the primary action of sulfonylureas in Type 2 Diabetes?
Stimulate insulin secretion from the pancreas to lower blood glucose
## Footnote
Examples include glimepiride, glyburide, and glipizide.
38
What do biguanides, such as Metformin, do in Type 2 Diabetes therapy?
Reduce hepatic glucose production (gluconeogenesis)
## Footnote
Biguanides primarily target the liver.
39
What is the effect of TZDs (thiazolidinediones) on insulin sensitivity?
Improve insulin sensitivity in the liver and muscle
## Footnote
Example includes pioglitazone.
40
How do α-glucosidase inhibitors function in Type 2 Diabetes management?
Slow carbohydrate absorption from the intestines
## Footnote
Examples include acarbose and miglitol.
41
List the types of insulin based on their onset of action.
* Rapid-acting insulin
* Short-acting insulin
* Intermediate-acting insulin
* Long-acting insulin
42
What is the onset time for rapid-acting insulin?
10–30 minutes
## Footnote
Examples include Novolog, Humalog, and Apidra.
43
What is the primary use of short-acting insulin?
Mealtime glucose control
## Footnote
Examples include Novolin R and Humulin R.
44
What is the onset time for intermediate-acting insulin?
1–2 hours
## Footnote
Examples include Novolin N and Humulin N.
45
What is the main characteristic of long-acting insulin?
Provides steady basal insulin coverage over 24 hours
## Footnote
Examples include Lantus and Levemir.
46
What role do lifestyle changes play in diabetes management?
Foundational to effective diabetes management
## Footnote
Must be combined with medication therapy.
47
What do GLP-1 receptor agonists do in diabetes therapy?
Improve insulin secretion and reduce glucose spikes
## Footnote
Example includes liraglutide.
48
True or False: Insulin types are used exclusively for mealtime glucose control.
False
## Footnote
Insulin types vary by onset and can also provide basal control.
49
Fill in the blank: TZDs decrease free fatty acid release and improve _______.
insulin sensitivity
50
What is the function of GIP in diabetes management?
Enhances glucose-dependent insulin secretion
## Footnote
GIP stands for glucose-dependent insulinotropic polypeptide.
51
What are the two main components that must be combined with oral agents for diabetes therapy to maximize effectiveness?
* Proper diet
* Physical activity
52
What are the first-generation sulfonylureas?
Chlorpropamide
## Footnote
First-generation sulfonylureas are older medications used to treat type 2 diabetes.
53
What is the prototype medication for second-generation sulfonylureas?
Glipizide
## Footnote
Second-generation sulfonylureas tend to have fewer side effects and are more effective than first-generation.
54
Name two other second-generation sulfonylureas.
* Glyburide
* Glimepiride
## Footnote
These medications also help in managing blood sugar levels in type 2 diabetes patients.
55
What is the prototype medication for meglitinides?
Repaglinide
## Footnote
Meglitinides stimulate insulin release from the pancreas similar to sulfonylureas.
56
What is the prototype medication for biguanides?
Metformin
## Footnote
Metformin is commonly the first choice for managing type 2 diabetes.
57
What are the pharmacological actions of biguanides?
* Reduces glucose production in the liver
* Increases glucose uptake in fat and skeletal muscles
* Decreases glucose absorption in the gastrointestinal tract
## Footnote
Biguanides are effective in controlling blood sugar levels.
58
What is the prototype medication for thiazolidinediones?
Pioglitazone
## Footnote
Thiazolidinediones work by increasing the body's sensitivity to insulin.
59
What do alpha-glucosidase inhibitors do?
Slows carbohydrate absorption and digestion
## Footnote
They help manage postprandial blood sugar levels.
60
What is the prototype medication for DPP-4 inhibitors?
Sitagliptin
## Footnote
DPP-4 inhibitors enhance incretin hormones to improve insulin secretion.
61
Name three other DPP-4 inhibitors.
* Saxagliptin
* Linagliptin
* Alogliptin
## Footnote
These medications aid in managing blood glucose levels.
62
What is the prototype medication for SGLT-2 inhibitors?
Canagliflozin
## Footnote
SGLT-2 inhibitors work by preventing glucose reabsorption in the kidneys.
63
What are the expected pharmacological actions of SGLT-2 inhibitors?
* Limits rise of glucose postprandial
* Excretes glucose through urine
* Promotes weight loss
## Footnote
These actions contribute to better blood sugar control.
64
What is the prototype medication for glucagon-like peptide 1 (GLP-1) agonists?
Semaglutide
## Footnote
GLP-1 agonists help regulate blood sugar levels and promote weight loss.
65
True or False: Thiazolidinediones decrease insulin resistance.
True
## Footnote
They enhance the body's response to insulin.
66
Fill in the blank: _______ is particularly effective for clients of Latino or African heritage in clinical trials.
Miglitol
## Footnote
This alpha-glucosidase inhibitor showed significant results in specific populations.
67
68
What are antidiabetic agents used for?
Control blood glucose levels in clients with type 2 diabetes mellitus
## Footnote
Used in conjunction with diet and exercise lifestyle changes.
69
What is metformin used for off-label?
Polycystic ovary syndrome (PCOS)
## Footnote
This is an off-label use for metformin.
70
What is a common complication of glipizide and repaglinide?
Hypoglycemia
71
What nursing actions should be taken for hypoglycemia?
Monitor for manifestations of hypoglycemia
Ensure the client knows how to treat hypoglycemia orally or that glucagon is available
72
What client education is necessary regarding recurrent hypoglycemia?
Notify the provider if there is a recurrent problem
73
What is a significant side effect of metformin?
Gastrointestinal effects: Anorexia, nausea, diarrhea
74
What weight change is commonly associated with metformin use?
Weight loss of 3 to 4 kg (6.6 to 8.8 lb)
75
What nursing actions should be taken for gastrointestinal effects from metformin?
Monitor for severity of these effects
Discontinue the medication if necessary
76
Which vitamin deficiencies can occur with metformin?
Vitamin B12 and folic acid deficiency
77
What is a serious complication associated with metformin?
Lactic acidosis
78
What are the symptoms of lactic acidosis?
Hyperventilation, myalgia, sluggishness, somnolence
79
What is the mortality rate of severe lactic acidosis?
50% mortality rate
80
How can severe lactic acidosis be treated?
Hemodialysis
81
Who should not use metformin?
Clients with renal insufficiency
82
What nursing actions should be taken for pioglitazone?
Monitor for edema, weight gain, and/or indications of heart failure
83
What elevation is a concern with pioglitazone?
Elevations in low-density lipoproteins (LDL) cholesterol
84
What nursing actions are necessary for monitoring hepatotoxicity with pioglitazone?
Perform baseline and periodic liver function tests
85
What should clients report when taking pioglitazone?
Manifestations of hepatotoxicity (jaundice or dark urine)
86
What effect does pioglitazone have on ovulation?
Can induce ovulation in females who had been anovulatory
87
What gastrointestinal effects are associated with acarbose?
Abdominal distention, cramping, hyperactive bowel sounds, diarrhea, excessive gas
88
What nursing actions should be taken for gastrointestinal effects from acarbose?
Monitor impact of these effects on the client
Discontinue the medication if necessary
89
What condition can result from acarbose use?
Anemia due to decreased iron absorption
90
What nursing actions should be taken for anemia caused by acarbose?
Monitor hemoglobin and iron levels
Discontinue the medication if necessary
91
What should be monitored with long-term use of acarbose?
Liver function
92
What is a unique nursing action regarding hypoglycemia treatment with acarbose?
Use glucose to treat hypoglycemia
93
What are common side effects of sitagliptin?
Headache, nausea, joint pain, hypersensitivity reactions, pancreatitis (rare)
94
What client education is necessary regarding pancreatitis with sitagliptin?
Notify the provider if manifestations of pancreatitis occur
95
What infections are associated with canagliflozin?
Cystitis, candidiasis, polyuria
96
What nursing actions should be taken for canagliflozin?
Monitor for manifestations of infection
97
What are the risks associated with canagliflozin in older adults?
Dizziness and risk for hypotension
98
What client education is important for clients taking canagliflozin?
Rise slowly from a seated position and report episodes of dizziness
99
What side effects are associated with semaglutide?
Nausea, loss of appetite, pancreatitis
100
What nursing actions should be taken for semaglutide?
Monitor for nausea and weight loss
101
What client education is necessary regarding pancreatitis with semaglutide?
Advise client to notify provider for manifestations of pancreatitis
102
What are the nursing considerations for Metformin (brand: Glucophage)?
Educate on Lactic Acid signs
Monitor for renal impairment
Stop for elective contrast CT and for admission
B12 and folic acid supplementation as needed
Potential for weight loss vs other PO meds
## Footnote
Metformin is primarily excreted unchanged by the kidneys, necessitating careful monitoring of renal function.
103
What signs should be educated about regarding Lactic Acid?
Signs of Lactic Acid buildup include nausea, vomiting, abdominal pain, weakness, and unusual fatigue.
## Footnote
Lactic acidosis is a rare but serious side effect of Metformin.
104
Why is it important to monitor for renal impairment in patients taking Metformin?
Because Metformin is excreted unchanged by the kidneys, renal impairment can lead to accumulation and increased risk of lactic acidosis.
## Footnote
Regular renal function tests are recommended for patients on Metformin.
105
When should Metformin be stopped?
Stop for elective contrast CT and for admission to the hospital.
## Footnote
Metformin should be temporarily discontinued before procedures involving contrast media to prevent potential renal complications.
106
What supplements may be needed for patients taking Metformin?
B12 and folic acid supplementation as needed.
## Footnote
Long-term Metformin use can lead to vitamin B12 deficiency.
107
What is a potential benefit of Metformin compared to other oral medications?
Potential for weight loss vs other PO meds.
## Footnote
Metformin is often preferred for overweight patients with type 2 diabetes due to its favorable effects on weight.
108
What is Metformin commonly known as?
Glucophage
109
What is the primary action of Metformin?
Sensitizes insulin receptors in target tissues
110
How does Metformin affect gastric glucose?
Inhibits gastric glucose reabsorption
111
What process does Metformin inhibit in the liver?
Hepatic gluconeogenesis
112
Fill in the blank: Metformin sensitizes _______ receptors in target tissues.
insulin
113
True or False: Metformin promotes hepatic gluconeogenesis.
False
114
What type of drug is Metformin?
Antidiabetic medication
115
What class of medications does Glipizide belong to?
Sulfonylurea (SU)
## Footnote
Sulfonylureas are a class of oral antidiabetic medications.
116
How do sulfonylureas stimulate insulin release?
By binding to sulfonylurea receptors on beta cells and blocking ATP-sensitive potassium channels
## Footnote
This leads to depolarization of the membrane and the opening of calcium channels, causing insulin secretion.
117
What is the main indication for the use of Glipizide?
Type 2 Diabetes Mellitus (T2DM)
## Footnote
It can be used as monotherapy or in combination with other antidiabetic agents.
118
What is a major adverse effect of Glipizide?
Hypoglycemia
## Footnote
It is more likely in patients with impaired kidney function or irregular meal patterns.
119
Which rare and serious skin reactions can occur with sulfonylureas?
SJS/TENS (Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis)
## Footnote
These are serious skin reactions associated with sulfonylureas.
120
What are some nursing considerations for patients taking Glipizide?
Educate & Monitor for Hypoglycemia
## Footnote
Teach patients to recognize early signs of low blood sugar and monitor glucose levels regularly.
121
True or False: Sulfonylureas can be used safely during pregnancy and breastfeeding.
False
## Footnote
Sulfonylureas cross the placenta and may harm the fetus.
122
What should be avoided when a patient is taking Glipizide?
Concurrent use of Beta Blockers
## Footnote
Beta blockers can mask symptoms of hypoglycemia, making it harder to detect low blood sugar.
123
Fill in the blank: Alcohol should be avoided while taking Glipizide due to the risk of _______.
hypoglycemia
## Footnote
Alcohol can increase the risk of hypoglycemia and cause a disulfiram-like reaction.
124
What triggers the insulin secretion in the pancreas when using sulfonylureas?
Opening of calcium channels
## Footnote
This occurs after the depolarization of the membrane due to ATP-sensitive potassium channel blockage.
125
Name two factors that increase the likelihood of hypoglycemia in patients taking Glipizide.
* Impaired kidney function
* Irregular meal patterns
## Footnote
These factors can lead to reduced clearance of the drug and increase the risk of severe hypoglycemia.
126
What cardiovascular risk is associated with some sulfonylureas?
Cardiovascular Toxicity
## Footnote
This is rare but has been noted with some sulfonylureas.
127
What drug class does Pioglitazone belong to?
Thiazolidinediones (TZDs)
## Footnote
TZDs are oral antidiabetic medications primarily used for managing Type 2 Diabetes Mellitus (T2DM).
128
What is the primary use of Pioglitazone?
Managing Type 2 Diabetes Mellitus (T2DM)
## Footnote
Pioglitazone can be used as monotherapy or in combination with other antidiabetic agents.
129
What is the mechanism of action (MOA) of Pioglitazone?
Activates PPAR-γ (Peroxisome Proliferator-Activated Receptor Gamma)
## Footnote
This activation enhances insulin sensitivity in muscle, fat, and liver.
130
How does Pioglitazone improve insulin sensitivity?
By activating insulin-responsive genes involved in carbohydrate and lipid metabolism
## Footnote
This action reduces insulin resistance in target tissues.
131
True or False: TZDs directly increase insulin secretion.
False
## Footnote
Unlike sulfonylureas, TZDs do not directly stimulate insulin secretion.
132
Name two common indications for Pioglitazone.
* Treatment of Type 2 Diabetes Mellitus
* Adjunct therapy with metformin or sulfonylureas
## Footnote
Can be used alone or in combination with other antidiabetic medications.
133
What is a serious adverse effect of Pioglitazone related to heart function?
Heart Failure (HF)
## Footnote
Caused by fluid retention due to the drug’s effects on sodium and water retention.
134
What effect can Pioglitazone have on premenopausal women?
May increase ovulation
## Footnote
This can lead to unintended pregnancies.
135
What risk is associated with long-term use of Pioglitazone?
Increased risk of bladder cancer
## Footnote
Long-term use has been linked to a slight increase in risk.
136
List two nursing considerations when administering Pioglitazone.
* Monitor for signs of heart failure
* Assess GU history for bladder health
## Footnote
Other considerations include monitoring liver function and drug interactions.
137
What should be monitored in patients taking Pioglitazone?
* Heart failure symptoms
* Liver function
* Drug interactions
## Footnote
Educate patients on the signs of heart failure and the importance of monitoring.
138
Fill in the blank: TZDs improve insulin sensitivity without causing _______.
hypoglycemia
## Footnote
This is particularly true when TZDs are used alone.
139
What lifestyle modifications should be reinforced for patients taking Pioglitazone?
Diet and exercise
## Footnote
These modifications help optimize blood sugar control.
140
What is a key teaching point regarding fluid retention risk?
Avoid in patients with moderate to severe heart failure
## Footnote
Patients should be educated on the risks associated with fluid retention.
141
What is the durable effect of TZDs compared to other oral agents?
Sustained glycemic control
## Footnote
TZDs provide more lasting glycemic control compared to some other medications.
142
What are non-insulin injectable antidiabetics?
Medications that assist in managing diabetes without the use of insulin
143
What is the prototype medication for amylin mimetics?
Pramlintide
144
What is the prototype medication for incretin mimetics?
Exenatide
145
List some other medications classified as incretin mimetics.
* Liraglutide
* Albiglutide
* Lixisenatide
* Dulaglutide
* Semaglutide
146
What is the expected pharmacological action of amylin mimetics?
Mimics amylin to decrease gastric emptying time and inhibit glucagon secretion
147
How does pramlintide affect postprandial glucose levels?
Reduces postprandial glucose levels
148
What is one way that amylin mimetics help with caloric intake?
They promote satiety
149
What is the expected pharmacological action of incretin mimetics?
Mimics glucagon-like peptide-1 to promote insulin release and decrease glucagon secretion
150
How do incretin mimetics affect gastric emptying?
They slow gastric emptying
151
What are the therapeutic uses of amylin mimetics?
* Supplemental glucose control for type 1 or type 2 diabetes
* Used with insulin therapy
152
What are the therapeutic uses of incretin mimetics?
* Supplemental glucose control for type 2 diabetes
* Can be used with oral antidiabetic medications
153
What is a common complication of amylin mimetics?
Nausea
154
True or False: Amylin mimetics can be used alone without insulin therapy.
False
155
Fill in the blank: Incretin mimetics can lead to ________ due to decreased appetite.
weight loss
156
What should clients report if they experience nausea while on amylin mimetics?
Manifestations to the provider
157
What is a self-limiting complication associated with amylin mimetics?
Reaction at injection sites
158
Glucagon-like Peptide 1 (GLP-1) class
(Ex: Semaglutide or Ozempic/Wegovy
159
What class of medication does Semaglutide belong to?
Glucagon-like Peptide-1 (GLP-1) class
160
What are the indications for Semaglutide?
* Type II DM mono- or adjunct treatment
* Chronic weight management
161
What is the route of administration for Semaglutide?
Injectable (SQ) medication
162
What are the common adverse effects of Semaglutide?
* Nausea
* Vomiting
* Diarrhea
163
What serious adverse effects are associated with Semaglutide?
* Increased risk of pancreatitis
* Renal impairment/AKI
* Hypersensitivity reactions
164
What is the mechanism of action (MOA) of Semaglutide?
Activates GLP-1 receptors to cause effects similar to endogenous incretins
165
What effects does Semaglutide have on gastric emptying?
Slows gastric emptying
166
How does Semaglutide affect insulin and glucagon?
* Stimulates release of insulin
* Inhibits postprandial glucagon release
167
What potential risk is associated with Semaglutide based on animal studies?
Possible MTC (medullary thyroid cancer)
168
What should nursing considerations include for patients taking Semaglutide?
* Educate & monitor on common signs and symptoms
* Educate on medication regimen
* Educate patient on different types of injectable medications
169
Fill in the blank: Semaglutide is also known as _______.
[Ozempic/Wegovy]
170
What class of medication does Pioglitazone belong to?
Thiazolidinediones (TZD) class oral antidiabetic medication
171
What is the mechanism of action (MOA) of Pioglitazone?
Activates PPAR gamma to turn on insulin-responsive genes responsible for carb & lipid metabolism
172
What is the primary indication for Pioglitazone?
Type II DM only
173
Can Pioglitazone be used as monotherapy?
Yes, but usually used as adjunct therapy
174
What is a major adverse effect of Pioglitazone?
Heart failure due to fluid retention
175
In which population is the risk of heart failure particularly notable?
Premenopausal women
176
What is another adverse effect associated with Pioglitazone?
Increased risk of fractures in women
177
What serious condition has been associated with Pioglitazone?
Bladder cancer
178
What should nurses educate patients about when prescribing Pioglitazone?
Signs of heart failure
179
What type of history should be assessed in patients taking Pioglitazone?
GU history & ROS
180
Which enzyme's inhibitors interact with Pioglitazone?
CYP2C8 inhibitors
181
Name one CYP2C8 inhibitor that can interact with Pioglitazone.
Atorvastatin, ketoconazole, rifampin, cimetidine, etc.
182
What class of medication does Acarbose belong to?
Alpha-glucosidase inhibitor class oral antidiabetic medication
183
What is the mechanism of action (MOA) of Acarbose?
Delays absorption of dietary carbohydrates to reduce postprandial hyperglycemia by inhibiting alpha glucosidase
184
What condition is Acarbose indicated for?
Type II DM only; mono- or combination therapy
185
What are the common adverse effects of Acarbose?
Gl-related effects, liver dysfunction with long-term high-dose treatment, anemia due to decreased absorption of iron
186
When treating hypoglycemia in patients using Acarbose with insulin or sulfonylurea, what should be used?
Glucose only
187
What should be monitored when a patient is on Acarbose?
Liver function tests (LFT) and signs/symptoms of liver dysfunction
188
Fill in the blank: Acarbose is an _______ inhibitor.
alpha-glucosidase
189
What is Tirzepatide (Mounjaro)?
A glucose-dependent insulinotropic (GIP) & glucagon-like Peptide-1 (GLP-1) class antidiabetic injectable (SQ) medication.
190
What are the indications for Tirzepatide?
Type II DM mono- or adjunct treatment.
191
What are the common adverse effects of Tirzepatide?
GI effects, including nausea, vomiting, diarrhea, constipation, and abdominal pain.
192
What are the serious risks associated with Tirzepatide?
Increased risk of pancreatitis and renal impairment/AKI.
193
What hypersensitivity reactions can occur with Tirzepatide?
Hypersensitivity reactions.
194
What potential risk is indicated from animal studies regarding Tirzepatide?
Possible medullary thyroid carcinoma (MTC).
195
What nursing considerations should be taken with Tirzepatide?
Educate & monitor on common signs and symptoms, educate on medication regimen, and educate patient on different types of injectable medications.
196
What is the mechanism of action (MOA) of Tirzepatide?
In addition to GLP-1 agonist effects, it also acts as an agonist at GIP receptors to produce similar effects.
