Diabetes Oral Medication (Exam 2)

Question 1

Sulfonylureas

Answer 1

glipizide
glyburide

-Most prescribed in second generation

-First category of oral drugs used to treat diabetes. (Type 2)

-Suffix: IDE

Question 2

Sulfonylureas: MOA

Answer 2

-Binding and closing the K-ATP channels in the pancreatic beta cells thereby STIMULATING secretion of insulin

-Increases the body’s sensitivity or response to insulin

-Reduces the release of glucose from the liver

Question 3

Sulfonylureas: Side Effects

Answer 3

-Hypoglycemia (More likely for patients who have liver/kidney dysfunction)

Question 4

Sulfonylureas: Nursing Consideration

Answer 4

-Do not take during pregnancy

-ETOH, NSAIDS, Tagamet, sulfa-based abx ponteniates side effects

Question 5

Biguanides

Answer 5

metformin

Question 6

Biguanide: MOA

Answer 6

-Lowers blood glucose by decreasing production of glucose in the liver

-Enhances glucose uptake and utilization by muscle

-Does not promote insulin release from the pancreas

-Does not cause hypoglycemia (In traditional sense)

Question 7

Biguanide: Side effects

Answer 7

Abdominal bloating, NVD, risk for acidosis in patients with elevated creatinine, do not use in patients with elevated ALT levels (Liver enzyme = Both acting on liver)

Question 8

Nursing Implication: Biguanides

Answer 8

-Monitor serum glucose levels, give 30 mintues before meals

-Metformin must be held for 48 hrs post IV contrast usage

-Do not use in those with heart failure, kidney disease, liver disease, or alcohol

Question 9

DPP4 Inhibitors

Answer 9

linaglipton
sazagliptin
stiagliptin

Question 10

DPP4 inhibitors: MOA

Answer 10

Inhibits dipeptidyl peptidase 4, an enzyme that inactivates the incretin hormone

-increases insulin realse by enhancing the activity of incretins

-Reduces glucagon relase

-Decreases heptaic glucose production

-Slow down digestion and decreaseappetite

Question 11

DPP4 Inhibitors: Side effects

Answer 11

Gastrointestinal probelms, N/D, stomach pain), flu-like symptoms, skin reaction, increase risk of pancreatitis

Question 12

DPP4 Inhibitors: Nursing consideration

Answer 12

-Used in combination with diet and lifestyle modificaitons

-Can be monotherapy or in combination with other diabetic medications (metformin)

-Not a high indidence of hypoglycemia

Question 13

GLP-I Receptor Agonists

Answer 13

dulaglutide
exentide
semglutide

Question 14

GLP-I Receptor Agonists: MOA

Answer 14

-Enhances glucose dependent insulin secretion

-Stimulates glucose-dependent release of insulin, inhibits posstrprandial release of glucagon, and suprpresses appetite

-Slowed gastric emptying

Question 15

GLP I Receptor Agonists: Nursing Consideration

Answer 15

-Usually used as adjunct therapy with metformin or other diabetic medication

-Plasma level peak in 2 hours, half life 2.5 hours

Question 16

GLP 1 Agonist: Side effects

Answer 16

NVD, injection site reaction, headache, upper respiratory infections, weight loss

Question 17

GLP 1 Agonist: Warning

Answer 17

-Black Box Warning: Risk of thyroid c-cell tumors

-Contraindicated for people who have a history of medullary thyroid carcinoma and in patients with multiple endocrine neoplasia syndrome type 2

-Do not use with history of pancreatitis

Question 18

What class of medications are synthesized from the proteins found in the saliva of the GILA MONSTER

Answer 18

GLP-1 Agonist

Question 19

Sodium-Glucose Cotransporter 2 Inhibitors. (SLG2)

Answer 19

dapagliflozin

-flozin

Question 20

SLG2 Inhibitor: MOA

Answer 20

-Prevents the kidneys from reabsorbing glucose back into the blood

-Allows kidneys to lower blood glucose levels and the excess glucose in the blood removed from the body via the urine

-Kidneys work by filtering glucose out of the blood and then reabsorbing glucose back into the blood—–the protein that absorb glucose are called sodium glucose transport proteins

-SLG2 inhibitors block these proteins, less glucose gets reabsorbed back into the blood

Question 21

SLGT-2 Inhibitors: Side Effects

Answer 21

-Increased risk of urinary tract infection, genital mycotic infections

-Hypotension, fainting, dizziness, fatigue

Question 22

SLGT-2 Inhibitors: Nursing Considerations

Answer 22

-Do not give it with someone who has ESRD or severe kidney disease

-Not FDA approved for type 1 (Only type 2)

-Being increasingly used for conditions such as heart failure, preventing worsening kidney disease

Question 23

Glucagon

Answer 23

-Hypoglycemia antidote

-Can be oral tablets or injection via SQ, IV, IM

-Oral tablets for an awake patient with an extremely low blood glucose level, but can still swallow talk

-Decrease LOC use IV/SC/IM

Question 24

Glucagon: MOA

Answer 24

Activates hepatic glucagon receptors, stimulates glycogenolysis and release of glucose

Question 25

Glucagon: Nursing consideration

Answer 25

-Has short half life so multiple doses are required

-Check finger stick 15 min post administration

Question 26

Things to consider: Steroids

Answer 26

-Steriods make your blood sugar RISE
(May need to alter insulin regimen at home, adjust basal dosage, increase scheduled doeses, etc.)

Question 27

Things to consider: Being sick

Answer 27

-Big Problem
-Sickness causes the body stress, may cause your body to release more glucose, so may have to check blood glucose more often, adjust unsuli regimnets

-patients are more prone to go into DKA, HHNS

-If stomach virus, may not be eating or drinking, must check blood sugar more often and treat as necessary

Question 28

Things to consider: Foods

Answer 28

-Crucial for people with diabetes, both type 1 and 2 to have a healthy variety of foods in their diet

-2 common meal planning methods: Plate method and carb counting

Question 29

Things to consider: Exercise

Answer 29

-Be carful if someone is changing their lifestyle by exercising more, can cause them to have elevated risk of hypoglycemia