AntiDiabetic agents Flashcards
3 p’s: of diabetes mellitus
polyuria, polyphagia, polydipsia
oral hypoglycemic
Type 2 diabetes
combined insulin and oral
hypoglycemic agents
Type 1 diabetes
INSULIN is given at
45 to 90 degree angle
Sites: of insulin injection
Deltoid
2) Abdominal area
3) Thigh
4) Buttocks
INSULIN is usually given in the
morning before
breakfast BUT it can be given several
times a day
should be rotated to prevent
LIPODYSTROPHY (tissue atrophy or
hypertrophy)
injections should be
1.5 inches apart
RAPID-ACTING drug
Humalog
SHORT-ACTING drug
Humulin R,
INTERMEDIATE-ACTING – contains protamine
NPH insulin Humulin N
Lente insulin Humulin L
LONG-ACTING - slower absorption first long acting rDNA human insulin
* Given OD usually at bedtime
Lantus
5 Signs and symptoms of hypoglycemia:
1) nervousness
2) tremor
3) confusion
4) sweating
5) increased PR
nursing management of hypoglycemia
orange juice, hard candy and sugar sweetened
beverages should be kept available
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
Somogyi Effect/ Rebound hyperglycemia
same experience with Somogyi effect but the
cause are different
- Body’s natural reaction to hormones that are
released as morning approaches
Dawn phenomenon
nursing management to rebound hyperglycemia
Check CBG just before bed
- Check again around 3 AM
- Test it again upon waking
Storage of Insulin:
Open insulin – 1 month at room temperature
3 months in the refrigerator
chemically related to sulfonamides
- stimulate pancreatic beta cells to secrete more
insulin
First and Second-Generation Sulfonylureas
First Generation
1. Short-acting oral drug
tolbutamide (Orinase)
Intermediate-acting drugs
acetohexamide (Dymelor)
tolazamide (Tolinase)
Long-acting drug
chlorpropamide (Diabinese)
Increase tissue response to insulin, decrease
glucose production by the liver
- Long duration with few side effects. More effective.
Second Generation
improves postprandial
glucose level (drugs)
glimepiride (Amaryl)
glipizide (Glucotrol)
Side effects of 2nd generation drugs
n and v, diarrhea,
abdominal pain
4 types of Non-Sulfonylureas
BIGUANIDES
ALPHA-GLUCOSIDASE INHIBITORS
THIAZOLIDINEDIONES
MEGLITINIDE
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
BIGUANIDES
biguanide drug SE: GI disturbances
metformin (Glucophage)
Inhibits alpha-glucosidase enzymes in the small
intestine
Does not cause hypoglycemia
The result is reduced rate of glucose absorption
postprandially.
ALPHA-GLUCOSIDASE INHIBITORS
ALPHA-GLUCOSIDASE INHIBITORS drug
acarbose (Precose) – used in clients who do not
achieve results with diet alone
miglitol (Glyset)
Decreases insulin resistance and improves blood
sugar control
THIAZOLIDINEDIONES
THIAZOLIDINEDIONES drug
rosiglitazone (Avandia)
Increases insulin secretion. Similar action with
sulfonylureas.
Not for client with liver problem because of possible
decreased liver metabolic rate
May cause hypoglycemia
MEGLITINIDE
MEGLITINIDE drug
repaglinide (Prandin)
nateglinide (Starlix)
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
Glucagon
