Antidiabetic drugs Flashcards
Metformin
Mechanism of action, adverse effects, and when would we discontinue metformin?
Mechanism of action: Reduces glucose production in liver, reduces absorption of glucose from intestine, causes increased sensitivity to glucose in the cells.
Adverse effects: Bloating, nausea, vomiting, diarrhea, lactic acidosis, metallic taste
Discontinue metformin the day of a test and 48 hours after radiological study involving iodine
Sulfonylureas mechanism of action
Increases beta cell secretion of insulin, inhibits the breakdown of insulin in the liver, enhances the action of insulin.
What generation is sulfonylureas, and what are the adverse effects
It is 2nd generation. Adverse effects are hypoglycemia, weight gain, skin rash, nausea, heartburn
What is the mechanism of action for thiazolidinediones and what is its onset of action?
It enhances receptor sensitivity to insulin. Onset of action is months
What is the mechanism of action for glinides and what is its onset of action
It increases the secretion of insulin in the pancreas, and has a shorter onset of action compared to thiazolidenediones
What is the mechanism of action for DPP-4 inhibitors
Decreases the breakdown of incretin, increases the secretion of insulin and decreases the release of glucagon
What four things are required for effective oral antidiabetic use
Lifestyle changes, monitor blood glucose levels, use of antidiabetic drugs and treatment of comorbid conditions
What is the increased effect of sulfonylureas and what interactions causes the increased effect of sulfonylureas
The increased effect seen would be hypoglycemia Alcohol, anabolic steroids MAOIs, beta-blockers, oral anticoagulants
What is the mechanism of action for sodium glucose cotransporter inhbitors
It prevents glucose reabsorption from the glomerular filtrate which in turn causes a decrease in blood glucose
What are the adverse effects of sodium-glucose cotransporter inhibitors?
Vaginal yeast infections, urinary tract infections, and insulin sensitvity
What are some symptoms of hypoglycemia?
Anxiety, tremors, confusion, drowsiness, dizziness, hypothermia, seizures
What causes a decreased effect of sulfonyureas?
Adrenergics, corticosteroids, thiazides, thyroid drugs
What is hypoglycemia, and how can it be treated?
Hypoglycemia is when one’s blood glucose drops to 4 mmol/L or below. It can normally be treated through diet so higher protein and lower carbs
Before a blood glucose-altering drug is given, what four things need to be obtained?
A health history, vital signs, blood glucose, drug interactions/potential complications
What are four areas of patient education that should be given for diabetic patients
The disease process, diet and exercise recommendations, self administion of insulin or oral drugs, potential complications
