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a_nclex > Antidiabetic Drugs > Flashcards

Antidiabetic Drugs Flashcards

1
Q

Glipizide (Glucotrol)

Chemical Classification

A

Sulfonylurea (2nd generation)

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2
Q

Glipizide (Glucotrol)

Mechanism of Action

A

Causes functioning beta cells in pancreas to release insulin; leading to drop in blood glucose levels; may improve insulin binding to insulin receptors or increase the number of insulin receptors with prolonged administration; may also reduce basal hepatic glucose secretion; not effective if patient lacks functioning beta cells

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3
Q

Glipizide (Glucotrol)

Uses

A

Type 2 diabetes mellitus

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4
Q

Glipizide (Glucotrol)

Contraindications

A

Hypersensitivity to sulfonylureas, type 1 diabetes, diabetic ketoacidosis

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5
Q

Glipizide (Glucotrol)

Side Effects

A

CNS: Headache, Weakness, Dizziness, Drowsiness, tinnitus, fatigue, vertigo
ENDO: HYPOGLYCEMIA
GI: HEPATOTOXICITY, CHOLESTATIC JAUNDICE, nausea, vomiting diarrhea, heartburn
HEMA: LEUKOPENIA, THROMBOCYTOPENIA, AGRANULOCYTOSIS, APLASTIC ANEMIA; increased AST, ALT, alk phos; PANCYTOPENIA, HEMOLYTIC ANEMIA
INTEG: rash, allergic reactions, pruritus, urticaria, eczema, photosensitivity, erythema, allergic vasculitis

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6
Q

Glipizide (Glucotrol)

Nursing Considerations

A

ASSESS:

  • HYPO/HYPERGLYCEMIC REACTION that can occur soon after meals; for severe hypoglycemia give IV D50W, then IV dextrose solution
  • Blood Glucose, A1c levels during treatment to determine diabetes control
  • Blood Dyscrasias: CBC at baseline and throughout treatment; report decreased blood count
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7
Q

Glipizide (Glucotrol)

Overdose Treatment

A

Glucose 25g IV via dextrose 50% sol, 50ml, 1mg glucagon, or carbohydrate depending on severity

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8
Q

Human Insulin Lispro (Humalog)

Type

A

Rapid Acting

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9
Q

Human Insulin Lispro (Humalog)

Onset

A

0.5-1 hr

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10
Q

Human Insulin Lispro (Humalog)

Peak Action

A

2-4 hr

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11
Q

Human Insulin Lispro (Humalog)

Nursing Implications

A

Not to be given IV

Give within 15 min of a meal

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12
Q

Human Insulin Lispro (Humalog)

Insulin Overdose Treatment

A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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13
Q 
Insulin Aspart (NovoLog)
(Type)
A

Rapid Acting

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14
Q 
Insulin Aspart (NovoLog)
(Onset)
A

5 to 15 min

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15
Q 
Insulin Aspart (Novolog)
(Peak Action)
A

0.75 to 1.5 hr

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16
Q 
Insulin Aspart (NovoLog)
(Nursing Implications)
A

Not to be given IV

Give within 15 min of a meal

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17
Q 
Insulin Aspart (NovoLog)
(Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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18
Q

Glipizide (Glucotrol)

Functional Classification

A

Antidiabetic

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19
Q 
Regular Insulin (Human)
(Type)
A

Short Acting

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20
Q 
Regular Insulin (Human)
(Peak Action)
A

2 to 3 hr

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21
Q 
Regular Insulin (Human)
(Nursing Implications)
A

Regular insulin may be given IV

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22
Q 
Regular Insulin (Human)
(Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

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23
Q 
Regular Insulin (Human)
(Onset)
A

30 to 60 min

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24
Q 
Isophane insulin (NPH)
(Onset)
A

1 to 2 hr

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25
Q 
Isophane Insulin (NPH)
(Peak Action)
A

6 to 12 hr

26
Q 
Isophane Insulin (NPH)
(Nursing Implications)
A

Not to be given IV

27
Q 
Isophane Insulin (NPH)
(Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

28
Q 
Insulin Glargine (Lantus)
(Type)
A

Long acting

29
Q 
Insuline Glargine (Lantus)
(Onset)
A

1.1 hr

30
Q 
Insulin Glargine (Lantus)
(Peak Action)
A

5hr (some sources say there is no peak)

31
Q 
Insulin Glargine (Lantus) 
(Nursing Implications)
A

Not to be given IV

Recommended to give once daily, acts as basal insulin

32
Q 
Insulin Glargine (Lantus)
Insulin Overdose Treatment)
A

Glucose 25g IV, via dextrose 50% sol, 50ml or glucagon 1mg

33
Q

Metformin

Functional Classification

A

Antidiabetic, oral

34
Q

Metformin

Chemical Classification

A

Biguanide

35
Q

Metformin

Mechanism of Action

A

Inhibits hepatic glucose production and increases sensitivity of peripheral tissue to insulin

36
Q

Metformin

Uses

A

Type 2 diabetes mellitus

37
Q

Metformin

Contraindications

A

Hypersensitivity; hepatic disease; creatinine >1.5mg/ml (males), >/= 1.4 (females); alcoholism; cardiopulmonary disease; acidemia; acute MI; cardiogenic shock; diabetic ketoacidosis; metabolic acidosis

38
Q

Metformin

Side Effects

A

CNS: Headache, Weakness, Dizziness, Drowsiness, tinnitus, fatigue, vertigo, Agitation
CV: HEART FAILURE
ENDO: LACTIC ACIDOSIS, hypoglycemia
GI: Nausea, Vomiting, Diarrhea, heartburn, anorexia, metallic taste
HEMA: THROMBOCYTOPENIA, decreased vit B12 levels
INTEG: rash

39
Q

Metformin

Nursing Considerations

A

ASSESS:

  • HYPOGLYCEMIC REACTIONS (sweating, weakness, dizziness, anxiety, tremors, hunger); hyperglycemic reactions soon after meals; these occur rarely with product, may occur when product combined with sulfonylureas
  • CBC (baseline, q3mo) during treatment check LFTs periodcially, AST, LDH, renal studies: BUN, creatinine during treatment; glucose, A1c; folic acid, vit B12 q1-2yr
  • LACTIC ACIDOSIS: malaise, myalgia, abdominal distress; risk increases with age, poor renal function; monitor electrolytes, lactate, pyruvate, blood pH, ketones, glucose

PERFORM/PROVIDE:
-Conversion from other oral hypoglycemic agents; change may be made without gradual dosage change; monitor serum glucose, urine ketones tid during conversion

40
Q

Pioglitazone (Actos)

Functional Classification

A

Antidiabetic; oral

41
Q

Pioglitazone (Actos)

Chemical Classification

A

Thiazolidinedione

42
Q

Pioglitazone (Actos)

Mechanism of Action

A

Specifically targets insulin resistance; an insulin sensitizer; regulates the transcription of a number of insulin-responsive genes

43
Q

Pioglitazone (Actos)

Uses

A

Type 2 diabetes mellitus

44
Q

Pioglitazone (Actos)

Contraindications

A

Breastfeeding, children, hypersensitivity to thiazolidinedione, diabetic ketoacidosis, CHF

45
Q

Pioglitazone (Actos)

Side Effects

A

CNS: Headache
CV: MI, HEART FAILURE, DEATH (GERIATRIC PATIENTS)
ENDO: hypo/hyperglycemia
MISC: Sinusitis, Upper Respiratory Tract Infection, Pharyngitis, HEPATOTOXICITY, edema, weight gain, anemia, macular edema; RISK OF BLADDER CANCER (USE >1yr)
MS: RHABDOMYOLYSIS

46
Q

Pioglitazone (Actos)

Nursing Considerations

A

ASSESS:

  • For CHF: excessive/rapid weight gain >5lb, dyspnea, edema; may need to be reduced or discontinued
  • RHABDOMYOLYSIS: muscle pain, increased CPK, weakness, swelling of affected muscles; if these occur and if confirmed by CPK, product should be discontinued
  • HYPOGLYCEMIC REACTIONS: sweating, weakness, dizziness, anxiety, tremors, hunger; hyperglycemic reactions soon after meals (rare); do not give with NYHA class III/IV heart failure
  • Check LFT’s periodically: AST, LDH; do not start treatment in active heart disease or if ALT>2.5x upper limit of normal; if treatment has already begun, follow closely with continuing ALT levels; if ALT increases to >3x upper limit of normal, recheck ALT as soon as possible; if ALT remains >3x upper limit of normal, discontinue
  • FBS, glycosylated HbA1c, plasma lipids/lipoproteins, BP, body weight during treatment
  • CBC with differential prior to and during therapy; more necessary in those with anemia

PERFORM/PROVIDE:
-Conversion from other oral hypoglycemic agents; change may be made with gradual dosage change; monitor serum glucose during conversion

47
Q

Repaglinide

Functional Classification

A

Antidiabetic

48
Q

Repaglinide

Chemical Classification

A

Meglitinide

49
Q

Repaglinide

Mechanism of Action

A

Causes functioning beta-cells in pancreas to release insulin, thereby leading to a drop in blood glucose levels; closes ATP-dependent potassium channels in the beta-cell membrane; this leads to the opening of calcium channels; increased calcium influx induces insulin secretion

50
Q

Repaglinide

Uses

A

Type 2 diabetes

51
Q

Repaglinide

Contraindications

A

Hypersensitivity to meglitinides; diabetic ketoacidosis, type 1 diabetes

52
Q

Repaglinide

Side Effects

A

CNS: Headache, Weakness, paresthesia
ENDO: HYPOGLYCEMIA
GI: nausea, vomiting, diarrhea, constipation, dyspepsia
INTEG: rash, allergic reactions
MISC: chest pain, UTI, allergy
MS: back pains, arthralgia
RESP: URI, sinusitis, rhinitis, bronchitis

53
Q

Repaglinide

Nursing Considerations

A

ASSESS:
-HYPO/HYPERGLYCEMIC REACTION, which can occur soon after meals: dizziness, weakness, headache, tremor, anxiety, tachycardia, hunger, sweating, abdominal pain, A1c, fasting, postprandial glucose during treatment

54
Q

Repaglinide

Overdose Treatment

A

Glucose 25g IV via dextrose 50% solution, 50ml or 1mg glucagon

55
Q

Sitagliptin

Functional Classification

A

Antidiabetic, oral

56
Q

Sitagliptin

Chemical Classification

A

Dipeptidyl-peptidase-4 inhibitor (DPP-4 inhibitor)

57
Q

Sitagliptin

Mechanism of Action

A

Slows the inactivation of incretin hormones; improves glucose homeostasis, improves glucose-dependent insulin secretion, lowers glucagon secretions, and slows gastric emptying time

58
Q

Sitagliptin

Uses

A

Type 2 diabetes mellitus as monotherapy or in combination with other antidiabetic agents

59
Q

Sitagliptin

Contraindications

A

Hypersensitivity, diabetic ketoacidosis (DKA)

60
Q

Sitagliptin

Side Effects

A

CNS: Headache
ENDO: hypoglycemia
GI: Nausea, Vomiting, abdominal pain, diarrhea, PANCREATITIS, constipation
MISC: Peripheral Edema
SYST: ANAPHYLAXIS, STEVENS-JOHNSON SYNDROME, ANGIOEDEMA

61
Q

Sitagliptin

Nursing Considerations

A

ASSESS:

  • HYPOGLYCEMIC REACTIONS: sweating, weakness, dizziness, anxiety, tremors, hunger; hyperglycemic reactions soon after meals
  • SERIOUS SKIN REACTIONS: swelling of face, mouth, lips, dyspnea, wheezing
  • PANCREATITIS: severe abdominal pain, nausea, vomiting; discontinue product
  • RENAL STUDIES: BUN, creatinine during treatment
  • Glycosylated hemoglobin A1c; monitor blood glucose (BG) as needed

PERFORM/PROVIDE:
-Conversion from other antidiabetic agents; change may be made with gradual dosage change

62
Q 
Isophane insulin (NPH)
(Type)
A

Intermediate Acting

a_nclex (40 decks)

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