Module 10 pt 2

Question 1

Metformin

Answer 1

oral anti-diabetic med
manage type 2 diabetes
first med prescribed for type 2
does not cause weight gain
used in combo therapy

Question 2

Metformin MOA

Answer 2

blood glucose regulation
-decreases glycogenesis in the liver
-decreases glycogenesis in the intestines
-increases glucose sensitivity in the peripheral tissues

Question 3

Metformin Pharmacokinetics

Answer 3

Oral administration
last about 12 hours for immediate release and 24 extended release
absorbed in the small intestines
is not metabolized
excreted unchanged in the urine

Question 4

Metformin Adverse effects

Answer 4

GI issues (diarrhea, nausea, and abd discomfort)

Lactic acidosis (rare, build up of lactic acid in the blood)
-s/s n/v, fatigue, fast deep breathing (kusmaul breathing), decreased urine output, and fruity smelling breath

Question 6

Assessing and documenting metformin

Answer 6

monitor renal function regularly
check prior to starting and at least yearly

pt should take with meals to decrease GI distress

Assess for lactic acidosis (muscle pain, trouble breathing, and stomach pain)

Question 7

contraindications of metformin

Answer 7

Renal impairment (excreted by kidneys, bad kidneys = hold on to metformin = lactic acidosis)

Liver disease (bad liver = inability to secrete metformin = lactic acidosis)

heart failure/ resp distress (increased risk of lactic acidosis)

acute or chronic metabolic acidosis (increase risk of lactic acidosis)

Question 8

Interactions of metformin

Answer 8

other antidiabetic drugs (additive effect increase risk of hypoglycemia)

reaction to contrast in imaging

alcohol (increase risk of lactic acidosis due to decrease function of the liver)

Question 9

Metformin patient education

Answer 9

follow prescription exactly

take with meals

s/s of lactic acidosis

encourage to follow healthy lifestyle to increase effectiveness of metformin

stop 48 hours prior to imaging with contrast and don’t take till 48 hours after imaging

educate s/s of hypoglycemia (carry candy)

Question 10

Glucagon

Answer 10

elevating agent

indicated by hypoglycemia tx

Question 11

MOA glucagon

Answer 11

blood glucose regulation

stimulates the liver to convert stored glycogen into glucose which is then released into the blood stream

Question 12

Pharmacokinetics glucagon

Answer 12

administered:
oral: if patient is conscious (10 min)
sub Q: takes 10 min
IM: about 10 min
IV: best bet. almost immediate (emergency)

Metabolized: Liver, kidneys, plasma
short half life of 3-6 mins
repeat doses might be needed

glucose should be rechecked in 5 mins then repeat dose could be administered

Question 13

adverse effects of glucagon

Answer 13

GI distress (NV)
injection site reaction (redness, swelling, itching)
hypertension due to its positive inotropic and cronotripic effects on the heart
resp distress

Question 14

inotropic

Answer 14

positive inotropic enhances the hearts ability to pump blood more

Question 15

cronotropic

Answer 15

creates faster heart beat

Question 16

Drug on drug glucagon

Answer 16

beta blockers: increase risk of sever hypertension

anticoagulants: increase risk of bleeding

Question 17

PT education glucagon

Answer 17

use exactly as prescribed
how to administer
s/s of hypoglycemia