DM (Pharm) Flashcards
What should be included in client education?
Action of medication (MOA)
How to take med
Hypoglycemia (side effect)
What is the goal of DM medication management?
Decrease blood glucose levels
Decrease risk of complications
Increase quality of life
Better health outcomes
What med is an example of a Biguanide?
What are some facts about this med?
What is the MOA?
Adverse effects include?
How often is the med taken?
W or w/o meals?
Metformin(Giucophage)
Most common type 2 DM med
Considered a 1st line drug
MOA: decrease hepatic glucose production (want to take this med at night)
GI (diarrhea, nausea)
Latic acidosis, hyperventilation
cold and clammy skin
Take as directed 1-2x day with meals
What med is an example of Sulfonylureas?
What are some facts about this med?
What is the MOA?
Adverse effects include?
How often is the med taken?
W or w/o meals?
What should the pt stop taking before starting this medication?
What type of allergy is contraindicated with these meds?
All meds start w/ G
(Glipizide, Gylburide, Glimepride)
Inexpensive, older group of medication
Stimulates the pancreas to make insulin
HYPOGLYCEMIA, weight gain
30 mins before meals
INSULIN!!
Sulfa allergy
What contraindications are commom among oral antidiabetic meds?
Age (w/ older pts medication stay in the systems longer)
Renal failure (anything with renal dsyfunction) places pts @ increased risk for hypoglycemia
What med is an example of a Thiazolidinediones (TZD)
What are some facts about this med?
What is the MOA?
Adverse effects include?
Pioglitazone (Actos)
Black box warning (can cause of excerbate HF)
Not given as often anymore d/t adverse effects
Targets insulin resistance
Peripheral edema, weight gain, reduced bone density
What med is an example of a Alpha-Glucosidase Inhibitors?
What are some facts about this med?
Adverse effects include?
How often is the med taken?
W or w/o meals?
Acarbose and Miglitol
Not commonly used in the US
Flatulence
Taken with 1st bite of food
What med is an example of a Dipeptidly Peptidase IV inhibitors (DDP-IV)?
What are some facts about this med?
What is the MOA?
Adverse effects include?
How often is the med taken?
Sitagliptin (Januvia)
newer class of drugs
Decrease hepatic glucose production, increase insulin production
H/A, Hypoglycemia (esp. if using insulin)
Take once a day
What med is an example of a Sodium Glucose Cotransporter Inhibitors (SGLT2)?
What is the MOA?
Adverse effects include?
How often is the med taken?
W or w/o meals?
Invokana, Farxiga
Works on the kidneys (blocks the re-uptake of glucose by allowing the pt. to excrete glucose)
Gential yeast infections/UTIs
Increased urination d/t excretion of glucose
Taken once a day before breakfast
What med is an example of a Glucagon-like peptide-1 (GLP-1) Agonists?
What are some facts about this med?
What is the MOA?
Adverse effects include?
How often is the med taken?
W or w/o meals?
Byetta, Ozempic (SubQ injection)
Not use as 1st-line treatment
Black box warning: Risk of developing thyroid C-cell tumors
Rotates sites with injection
Decrease hepatic glucose production, increase insulin profuction, slows gastric emptying (helps w/ satiety)
Nausea, weight loss, Vomiting, diarrhea
Taken before meals, once day or once a week
What is the MOA of Insulin?
HINT: 3-4
What are the contraindications?
What is important about insulin? What is it?
What should only be used when drawing up insulin?
Pt. education includes (3 things)
Decrease glucose levels, converts glucose into glycogen, and promotes, energy storage
Take pt. off of sulfonylureas before taking insulin
Beta blocks (can mask hypoglycemia symptoms–> fast heart rate, shakiness)
HIGH-ALERT MED
Insulin syringes (or insulin pens should be use if available)
Hypglycemia, injection technique, action and timing of insulin
What are some important facts about SHORT-ACTING INSULIN?
Where is it given?
What’s the onset, peak, and duration?
Taken with meals? How long before meals?
What does this med lowers?
Regular (Humulin R, Novolin R)
ONLY INSULIN GIVEN IV
SubQ injection
Onset: 30-60 mins
Peak: 2-5hrs
Duration: 6-10hrs
Given 30 mins before meals
Lowers postprandial blood glucose levels
What are some important facts about INTERMEDIATE-ACTING INSULIN?
Where is it given?
What’s the onset, peak, and duration?
How often is this med given?
NPH “Cloudy”
SubQ injection
Onset: 1-2hrs
Peak: 4-8hrs
Duration: 10-18hrs
Given once or twice daily
What are some important facts about LONG-ACTING INSULIN?
Where is it given?
What’s the onset, peak, and duration?
How often is this med given?
Lantus, Trisiba, Levemir
Take with the biggest meal
SubQ injection
Onset: 1-2hrs
Peak: none
Duration: 12-36hrs
GIven once a day
What is the carbohydrate ratio?
15 grams= 1 unit
