Chapter 32 - Antidiabetic Drugs Flashcards Preview

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Flashcards in Chapter 32 - Antidiabetic Drugs Deck (74)
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When are oral antidiabetic drugs given?

usually given 30 minutes before meals


What is hypoglycemia?

low blood glucose level <50mg/dL


What is the most rapid acting insulin?

Human-based insulins

1. Insulin lispro (Humalog, similar to endogenous insulin)

2. Insulin aspart (NovoLog)

3. Insulin glulisine (Apidra, newest) *if cloudy, do not use. Must be clear. Onset: 5-15 minutes Duration: 3-5 hours may be given SC or by SC cont. infusion *No IV *Pt must eat meal after injection


Since biguanides do not increase insulin secretion from the pancreas, what does that mean?

does not cause hypoglycemia and weight gain *results in decreased insulin resistance


How to treat gestational diabetes?

Insulin must be given to prevent birth defects; usually subsides after delivery


What is a Biguanide and and example?

Oral antidiabetic drug

metformin (Glucophage)*


What is there potential for with sulfonylureas?

Potential for cross allergy in pts allergic to sulfonamide antibiotics*


What is FPG? What does >126 mg/dL but <110 mg/dL mean? How do you find those numbers?

Fasting plasma glucose levels; may indicate "prediabetes"

Glucose tolerance test (oral glucose challenge)

*screening recommended every 3 years when 45 years or older


What are mild hypoglycemic cases treated with?


more protein, less carbs prevents rebound postprandial hypoglycemia


What is the treatment for DM?

Type 1: insulin therapy

Type 2: lifestyle changes, oral drug therapy, insulin when the previous no longer provides glycemic control


Example of Glinides (2)

1. repaglinide (Prandin)

2. nateglinide (Starlix)


What hormone(s) does the pancreas secrete?

Insulin and glucagon both assist in glucose regulation


Important when monitoring for therapeutic response:

Measure hemoglocin A1c to monitor long-term compliance with diet and drug therapy


Example of alpha-glucosidase inhibitors (2)

1. acarbose (Precose)

2. miglitol (Glyset)


What are other treatments for type 2 diabetes?

Lifestyle modifications: diet, exercise, smoking cessation, weight loss


How long should a pt rotate sites for insulin administration?

Rotate sites for about 1 week before rotating to a new location

 0.5-1 inch away from previous site


How common is Diabetes Mellitus Type 1 vs Type 2?

Type 1: <10% of all diabetes

Type 2: 90% of all cases (most common)


Are insulin orders/prepared dosages second-checked with another nurse?

YES. Yellow. Know this. Do not ever forget that this needs to be second checked. Unforgivable.


In regards to fat metabolism, what does insulin do?

stimulates lipogenesis (production and accumulation of fat)

inhibits lipolysis (breakdown/destruction of fat)


What 2 things does inadequate insulin elevate?

Inadequate insulin elevates:

1. blood glucose levels (hyperglycemia)

2. triglyceride levels


What 2 things must be assessed before giving glucose-level-altering drugs?

1. pt's ability to consume food

2. nausea/vomiting

hypoglycemia may occur if antidiabetics are given and pt does not eat


Which drug primarily affects GI tract: abdominal bloating, nausea, cramping, diarrhea, and feeling of fullness?

Biguanide: Metformin


What is macrovascular/microvascular?

Both are major long-term complications of DM (1 and 2)

Macrovascular is atherosclerotic plaque in coronary, cerebral, and peripheral arteries; think MACRO as BIG

Microvascular is capillary damage: retinopathy, neuropathy, nephropathy; think MICRO ias small. capillary.


What is diabetes mellitus primarily, and how many types are there?


Disorder of carbohydrate metabolism that leads to hyperglycemia

2 Types


What 4 things are important to obtain/document prior to giving glucose-level-altering drugs?

1. thorough history

2. vital signs

3. blood glucose level, A1C level

4. potential complications/drug interactions



People's Blood Takes Vacation



What complications occur from Type 1 Diabetes Mellitus?

Diabetic ketoacidosis (DKA)

Hyperosmolar nonketotic syndrome


Which 2 sulfonylureas need to be taken when?

1. glyBuride taken with breakfast THINK: glyB needs breakfast

2. glipizide taken 30 minutes prior to breakfast THINK: "ZIP" it down before breakfast



Glinides, slide 29 Thiazolidinediones (glitazones), slide 30 Alpha-glucosidase inhibitors (must be taken with meals), slide 32 Sulfonylureas, slide 36 (put in the yellow stuff and left out the white) Insulin, slide 42


How many types of antidiabetic drugs are there, and what are they?

2 types:

1. insulins

2. oral hypoglycemic drugs

both aim to produce normal blood glucose states


Which drugs cause and do not cause weight gain?


1. thiazolidinediones

2. glinides


Do not cause:

1. biguanides

2. alpha-glucosidase inhibitors