Anti-diabetic Drugs Flashcards
Rapid
Lispro, aspart
- onset: < 30min
- Peak: 30-90 min
- duration: 3-5 H
Short
Regular
- Only IV insulin
- onset: 30 min
- Peak: 2-5 H
- Duration: 4-12 H
Intermediate
Isophane NPH
- only cloudy insulin
- onset: 1-2 H
- Peak: 4-12 H
- Duration: <24 H
Long
glargine, detemir
- onset: 1 H
- Peak: glargine - no peak; detemir - 6-8 H
- Duration: 24 H
Oral Antidiabetic Agents
MOA:
- increase cell sensitivity
- increase insulin production
- increase incretin (by SI) to increase insulin
- decrease glycogen breakdown
- decrease breakdown of starch in GI
Contraindication:
- type-1 (many are category C –> use insulin instead during pregnancy)
Caution:
- requires next 24H meal plan
- hepatic and renal impairment
SE:
- oral antidiabetics increase cardiac function and O2 demand
- monitor angina, dysrhythmias
Patient education:
- keep log of BG with factors affecting (diet, infection, medication, activity)
Nursing:
- avoid alcohol (high carb = hyperglycemia; liver failure = hypoglycemia, low PO intake = malnutrition/hypoglycemia, interaction with oral agents = disulfiram reaction)
- keep BG below 150, prevent hypoglycemia
glimepiride, glipizide, glyburide
contraindication
- RF, liver failure, pregnancy, lactation, surgery and severe infection
metformin
Contraindication
- severe infection
- acute disorders (shock, hypoxia)
- chronic alcohol use disorder
acarbose
MOA:
- blocks pancreatic amylase (prevent sucrose breakdown = dextrose and fructose)
Contraindication:
- IBD, bowel ulceration/obstruction
SE:
- vitamin, GI
Insulin
MOA:
- promote cellular uptake of glucose –> low BG
- convert glucose into glycogen –> low BG
- promote cellular uptake of potassium –> low K
Indication:
- all type I, type II (when oral agents dont work), acute stress, gestational, acute exacerbation of DM, hyperkalemia
