Diabetic Medication

Question 1

Name 5 Types of Oral Hypoglycemic Medication

Answer 1

1. Sulfonylureas
2. Biguanides
3. Alpha-Glucosidase Inhibitors
4. Thiazolidinediones
5. Meglitinides

Question 2

Name 3 Sulfonylureas

Answer 2

1. Glipizide (Glucotrol)**
2. Glyburide (Glynase)
3. Glimepiride (Amaryl)

Question 3

Sulfonylureas Mechanism of Action

Answer 3

Works to increase output on insulin by beta cells in pancreas. Also increases sensitivity of insulin receptors at target tissues

Question 4

RN Implication for Sulfonylureas

Answer 4

1. Best taken 30 min prior to meal

2. Use cautiously in elderly patients

Question 5

Side Effects for Sulfonylureas

Answer 5

1. Hypoglycemia due to missed meals or use of alcohol.

Question 6

Name 1 Biguanide

Answer 6

1. Metformin (Glucophage)

Question 7

Biguanide Mechanism of Action

Answer 7

Decrease liver output of sugar and increase peripheral insulin sensitivity.

Question 8

Biguanide Nursing Implication

Answer 8

1. Monitor kidney testing (serum creatinine)
2. Contraindicated if pt has CHF, alcohol abuse, metabolic acidosis, liver of kidney disease or is >80 yrs old.
3. Take with food
4. DC after OR, dye (contrast) studies for 48 hrs or until kidney function is normal.

Question 9

Biguanide Side Effect

Answer 9

1. GI distress and diarrhea

2. Lactic acidosis

Question 10

Name 1 Alpha-Glucosidase Inhibitors

Answer 10

1. acarbose (Precose)

Question 11

AGI Mechanism of Action

Answer 11

Blocks enzymes in small intestines responsible for breaking down complex carbohydrates into monosaccharides and delays absorption

Question 12

AGI Side Effect

Answer 12

Most common Adverse Effect is GI related. Anti-gas medication will decrease effectiveness.

Question 13

Name 1 Thiazolidinediones

Answer 13

1. rosiglitazone (Avandia)

Question 14

Thiazolidinediones Mechanism of Action

Answer 14

Reduces blood glucose by decreasing insulin resistance & inhibiting hepatic glucogenesis

Question 15

Thiazolidinediones Side Effect

Answer 15

1. Fluid retention
2. Headache
3. Weight gain

Question 16

Thiazolidinediones RN Implication

Answer 16

1. May take 3-4 months of therapy
2. Take daily wt
3. listen to lung sounds
4. Monitor for edema

Question 17

Maglitinides Class Information

Answer 17

1. Newer class
2. Acts by stimulating release of insulin from pancreatic islet cells
3. Short duration of 3-4 hrs, = efficacy to sulfonyureas
4. Most common Adverse Effect is HYPOGLYCEMIA**

Question 18

Insulins

Answer 18

1. Very Rapid Acting
2. Short (Rapid) Acting
3. Intermediate Acting
4. Long Acting

Question 19

Name 2 Very rapid acting insulin

Answer 19

1. Lispro (Humalog)

2. Aspart (Novalog)

Question 20

Very Rapid Acting Insulin Action

Answer 20

1. 10 minute onset
2. Peaks in 1 hour
3. Lasts 3-4 hours

Question 21

Very Rapid Acting RN Implication

Answer 21

1. Clear solution

2. Give 15 minutes before meal

Question 22

Insulin

Answer 22

1. Monitor Blood Sugar Level

2. Draw Rapid Acting Before Long (Clear before cloudy)

Question 23

Name 1 Short (Rapid) Acting Insulin

Answer 23

1. Regular

Question 24

Short Acting Action

Answer 24

1. Onset in 30 Minutes
2. Peaks in 3-5 hours
3. Lasts 6-10 hours

Question 25

Short Acting RN Implication

Answer 25

1. Clear solution

2. Give 30 minutes prior to meal

Question 26

Name 2 Intermediate Acting Insulin

Answer 26

1. NPH

2. Lente

Question 27

Intermediate Insulin Action

Answer 27

1. Onset 1 hour
2. Peaks 6-12 hours
3. Lasts 20-24 hours

Question 28

Intermediate RN Implication

Answer 28

1. Cloudy solution

2. Rotate prior to use

Question 29

Name 2 Long Acting Insulin

Answer 29

1. Glargine (Lantus)

2. Detemir (Levemir)

Question 30

Lantus Action

Answer 30

1. Onset in 1 hour
2. No peak
3. Lasts 24 hours

Question 31

Lantus RN Implication

Answer 31

1. Clear solution

2. DO NOT MIX C OTHERS

Question 32

Levemir Action

Answer 32

1. Onset 3-4 hours
2. No peak
3. Lasts 24 hours

Question 33

Levemir RN Implication

Answer 33

1. Clear solution

2. DO NOT MIX C OTHERS