AntiDiabetic agents

Question 1

3 p’s: of diabetes mellitus

Answer 1

polyuria, polyphagia, polydipsia

Question 2

oral hypoglycemic

Answer 2

Type 2 diabetes

Question 3

combined insulin and oral

hypoglycemic agents

Answer 3

Type 1 diabetes

Question 4

INSULIN is given at

Answer 4

45 to 90 degree angle

Question 5

Sites: of insulin injection

Answer 5

Deltoid

2) Abdominal area
3) Thigh
4) Buttocks

Question 6

INSULIN is usually given in the

Answer 6

morning before
breakfast BUT it can be given several
times a day

Question 7

should be rotated to prevent

Answer 7

LIPODYSTROPHY (tissue atrophy or

hypertrophy)

Question 8

injections should be

Answer 8

1.5 inches apart

Question 9

RAPID-ACTING drug

Answer 9

Humalog

Question 10

SHORT-ACTING drug

Answer 10

Humulin R,

Question 11

INTERMEDIATE-ACTING – contains protamine

Answer 11

NPH insulin Humulin N

Lente insulin Humulin L

Question 12

LONG-ACTING - slower absorption first long acting rDNA human insulin
* Given OD usually at bedtime

Answer 12

Lantus

Question 13

5 Signs and symptoms of hypoglycemia:

Answer 13

1) nervousness
2) tremor
3) confusion
4) sweating
5) increased PR

Question 14

nursing management of hypoglycemia

Answer 14

orange juice, hard candy and sugar sweetened

beverages should be kept available

Question 15

happens when you take insulin before bed

• results in morning high blood sugar
• common in type 1 and type 2
• Night sweats may be a symptom

Answer 15

Somogyi Effect/ Rebound hyperglycemia

Question 16

same experience with Somogyi effect but the
cause are different
- Body’s natural reaction to hormones that are
released as morning approaches

Answer 16

Dawn phenomenon

Question 17

nursing management to rebound hyperglycemia

Answer 17

Check CBG just before bed

2. Check again around 3 AM
3. Test it again upon waking

Question 18

Storage of Insulin:

Answer 18

Open insulin – 1 month at room temperature

3 months in the refrigerator

Question 19

chemically related to sulfonamides
- stimulate pancreatic beta cells to secrete more
insulin

Answer 19

First and Second-Generation Sulfonylureas

Question 20

First Generation

1. Short-acting oral drug

Answer 20

tolbutamide (Orinase)

Question 21

Intermediate-acting drugs

Answer 21

acetohexamide (Dymelor)

tolazamide (Tolinase)

Question 22

Long-acting drug

Answer 22

chlorpropamide (Diabinese)

Question 23

Increase tissue response to insulin, decrease
glucose production by the liver
- Long duration with few side effects. More effective.

Answer 23

Second Generation

Question 24

improves postprandial

glucose level (drugs)

Answer 24

glimepiride (Amaryl)

glipizide (Glucotrol)

Question 25

Side effects of 2nd generation drugs

Answer 25

n and v, diarrhea, | abdominal pain

Question 26

4 types of Non-Sulfonylureas

Answer 26

BIGUANIDES ALPHA-GLUCOSIDASE INHIBITORS THIAZOLIDINEDIONES MEGLITINIDE

Question 27

Reduces hepatic production of glucose from stored glycogen  Decreases serum glucose following a meal  Does not produce hypoglycemia or hyperglycemia  Not recommended for clients with renal problem

Answer 27

BIGUANIDES

Question 28

biguanide drug SE: GI disturbances

Answer 28

metformin (Glucophage)

Question 29

Inhibits alpha-glucosidase enzymes in the small intestine  Does not cause hypoglycemia  The result is reduced rate of glucose absorption postprandially.

Answer 29

ALPHA-GLUCOSIDASE INHIBITORS

Question 30

ALPHA-GLUCOSIDASE INHIBITORS drug

Answer 30

acarbose (Precose) – used in clients who do not achieve results with diet alone miglitol (Glyset)

Question 31

Decreases insulin resistance and improves blood | sugar control

Answer 31

THIAZOLIDINEDIONES

Question 32

THIAZOLIDINEDIONES drug

Answer 32

rosiglitazone (Avandia)

Question 33

Increases insulin secretion. Similar action with sulfonylureas.  Not for client with liver problem because of possible decreased liver metabolic rate  May cause hypoglycemia

Answer 33

MEGLITINIDE

Question 34

MEGLITINIDE drug

Answer 34

repaglinide (Prandin) | nateglinide (Starlix)

Question 35

hyperglycemic hormone secreted by alpha cells • Increases blood sugar by stimulating glycogen breakdown in the liver • subQ, IM, IV • Used to treat insulin-induced hypoglycemia when other methods are not available (semiconscious or unconscious patients) • Onset 5 to 20 minutes

Answer 35

Glucagon