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Pharmacology - NCLEX > Diabetic Medications (45) > Flashcards

Diabetic Medications (45) Flashcards

1
Q

GLUCAGON: Nursing Considerations

A
  • IV: onset immediate, peak 30 minutes, duration 60–90 minutes
  • subQ: onset within 10 minutes, peak 13–20 minutes, duration 30 minutes
  • Monitor blood glucose until client is asymptomatic
  • Use reconstituted mixture within 15 minutes of mix
  • OTC, Rx; Preg Cat B
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2
Q

GLUCAGON: Side Effects

A
  • Nausea, vomiting
  • Dizziness
  • Hypotension
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3
Q

GLUCAGON: Purpose

A

Acute management of hypoglycemia, facilitation of diagnostic tests through temporary inhibition of GI tract movement

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4
Q

INSULIN, REGULAR: Nursing Considerations

A
  • Comes in 100 units/milliliter vial
  • Only insulin that can be given IV in non-emergency situations
  • subQ: onset 15–30 minutes, peak 30–90 minutes, duration 3–5 hours
  • IV: onset 10–30 minutes, peak 10–30 minutes, duration 30–60 minutes
  • Read insulin pen instructions carefully
  • May be mixed with NPH only in same syringe; draw regular insulin first
  • Do not use in insulin pumps
  • Monitor blood glucose
  • Do not rub site after subQ injection
  • OTC (in some states), Rx; Preg Cat B
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5
Q

INSULIN, REGULAR: Side Effects

A
  • Hypoglycemia
  • Lipodystrophy
  • Allergic reaction
  • Hypokalemia
  • Headache
  • Edema
  • Blurred vision
  • Flushing
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6
Q

INSULIN, REGULAR: Purpose

A

Management of diabetes mellitus

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7
Q

INSULIN LISPRO: Nursing Considerations

A
  • Take within 15 minutes of eating and immediately after mixing, with combined therapy
  • May be used in children in combination with sulfonylureas
  • Onset 15–30 minutes , peak 30–90 minutes, duration 3–5 hours
  • May be used in an external insulin pump
  • Monitor blood glucose
  • May be administered IV in emergency situations under medical supervision with close blood-glucose monitoring
  • If administered using insulin pen, read instructions carefully
  • Do not mix with other insulins
  • Available in combination with other insulin
  • Rx; Preg Cat B
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8
Q

INSULIN LISPRO: Side Effects

A
  • Hypoglycemia
  • Lipodystrophy
  • Allergic reactions
  • Headache
  • Edema
  • Blurred vision
  • Hypokalemia
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9
Q

INSULIN LISPRO: Purpose

A

Management of diabetes mellitus

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10
Q

INSULIN-ISOPHANE SUSPENSION (NPH): Nursing Considerations

A
  • Comes in 100 units per milliliter vial, as well as in combination with regular insulin in a 50/50 proportion and 75/25 proportion
  • subQ: onset 1–2 hours, peak 4–12 hours, duration 16 hours
  • Read administration instructions carefully
  • Do not give IV
  • Monitor blood glucose
  • OTC (in some states), Rx; Preg Cat B
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11
Q

INSULIN-ISOPHANE SUSPENSION (NPH): Side Effects

A
  • Hypoglycemia
  • Lipodystrophy
  • Allergic reactions
  • Headache
  • Edema
  • Blurred vision
  • Flushing
  • Hypokalemia
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12
Q

INSULIN-ISOPHANE SUSPENSION (NPH): Purpose

A

Management of diabetes mellitus

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13
Q

INSULIN GLARGINE: Nursing Considerations

A
  • Onset 4-6 hours, no pronounced peak, duration 24 hours
  • Must inject at same time each day
  • Not the drug of choice for diabetic ketoacidosis (use a short-acting insulin)
  • Higher incidence of injection site pain compared with NPH insulin
  • Monitor blood glucose
  • Do not administer IV or via insulin pump
  • Do not mix with any other insulin
  • Rx; Preg Cat C
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14
Q

INSULIN GLARGINE: Side Effects

A
  • Hypoglycemia
  • Lipodystrophy
  • Allergic reactions
  • Headache
  • Edema
  • Blurred vision
  • Flushing
  • Hypokalemia
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15
Q

INSULIN GLARGINE: Purpose

A

Management of diabetes mellitus

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16
Q

INSULIN ASPART: Nursing Considerations

A
  • The only insulin analog approved for use in external pump systems for continuous subQ insulin infusion
  • Onset 15–30 minutes, peak 1–3 hours, duration 3–5 hours
  • May be administered IV in emergency situations under medical supervision with close blood-glucose monitoring
  • Provide a meal (within 5–10 minutes )following the injection
  • Rx; Preg Cat B
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17
Q

INSULIN ASPART: Side Effects

A
  • Hypoglycemia
  • Lipodystrophy
  • Hypokalemia
  • Allergic reactions
  • Headache
  • Edema
  • Blurred vision
  • Flushing
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18
Q

INSULIN ASPART: Purpose

A

Management of diabetes mellitus

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19
Q

SITAGLIPTIN: Nursing Considerations

A
  • Take with or without food
  • Do not split, crush, or chew
  • Contact provider immediately if symptoms of pancreatitis: persistent, severe abdominal pain with or without vomiting
  • Rx; Preg Cat C
20
Q

SITAGLIPTIN: Side Effects

A
  • Pancreatitis
  • Headache
  • Nausea, vomiting
  • Acute renal failure
  • Peripheral edema
  • Anaphylaxis
21
Q

SITAGLIPTIN: Purpose

A

Management of type 2 diabetes as monotherapy or in combination with other antidiabetic agents

22
Q

ROSIGLITAZONE MALEATE: Nursing Considerations

A
  • PO: once a day or in 2 divided doses
  • Take without regard to meals
  • Have a quick source of sugar or a glucagon emergency kit available
  • Wear medical information tag
  • Avoid OTC, herbals, nitrates, and insulin unless approved by provider
  • Rx
23
Q

ROSIGLITAZONE MALEATE: Side Effects

A
  • Headache, fatigue
  • MI, CHF
  • Weight gain
  • Hepatotoxicity
  • Increased cholesterol levels
  • URI, sinusitis
  • Back pain
  • Pulmonary edema
24
Q

ROSIGLITAZONE MALEATE: Purpose

A

Management of type 2 diabetes

25
**PIOGLITAZONE:** Nursing Considerations
* Take around the same time each day, once daily, with or without food * Full therapeutic effects may require 2 or more weeks * Use in conjunction with diet and exercise regimen * ***May exacerbate CHF***; monitor for edema and lung sounds * August 2011, FDA issued alert: use of drug for ***more than 1 year is associated with increased risk of bladder cancer*** * Rx; Preg Cat C
26
**PIOGLITAZONE:** Side Effects
* Headache * Sinusitis * Respiratory infection * Muscle pain * MI, heart failure * Hepatotoxicity
27
**PIOGLITAZONE:** Purpose
Management of type 2 diabetes
28
**METFORMIN:** Nursing Considerations
* PO: twice a day with meals to decrease GI upset and provide best absorption; may also be taken as one dose * Can crush tablets and mix with juice or soft foods for ease of swallowing * Do not crush, chew, or break extended-release tablet * ***Be aware of signs of lactic acidosis:*** hyperventilation, fatigue, malaise, chills, myalgia, sleepiness * Have a quick source of sugar or a glucagon emergency kit available * Monitor blood sugar * Wear medical information tag * Rx; Preg Cat B
29
**METFORMIN:** Side Effects
* Headache * Weakness, dizziness, drowsiness * Agitation * Nausea, vomiting, diarrhea * Lactic acidosis * Thrombocytopenia * Rash
30
**METFORMIN:** Purpose
Management of type 2 diabetes
31
**GLYBURIDE:** Nursing Considerations
* ***Assess for symptoms of cholestatic jaundice:*** dark urine, pruritus, yellow sclera (rare) * Take at breakfast; onset 2–4 hours, peak 4 hours, duration 24 hours * Have a quick source of sugar or a glucagon emergency kit available * Monitor blood sugar * Wear medical information tag * Rx; Preg Cat C
32
**GLYBURIDE:** Side Effects
* Headache * Weakness, dizziness * Photosensitivity * GI disturbances * Allergic skin reactions * Thrombocytopenia * Cholestatic jaundice * Blurred vision * Increased liver enzymes * Hepatotoxicity * Joint pain
33
**GLYBURIDE:** Purpose
Management of type 2 diabetes
34
**GLIPIZIDE:** Nursing Considerations
* ***Do not drink alcohol since it can produce a disulfiram reaction:*** nausea, headache, cramps, flushing, hypoglycemia * ***Assess for symptoms of cholestatic jaundice:*** dark urine, pruritus, yellow sclera (rare) * Take at breakfast; onset 1–1.5 hours, peak 1–3 hours, duration 10–24 hours * Immediate-release: take 30 minutes before meals, since absorption is delayed by food * Have a quick source of sugar or a glucagon emergency kit available * ***May cause hemolytic anemia when used with sulfonylurea agents*** * Monitor blood sugar * Wear medical information tag * Rx; Preg Cat C
35
**GLIPIZIDE:** Side Effects
* Headache * Weakness, dizziness * Drowsiness * Photosensitivity * Increased liver enzymes * Cholestatic jaundice
36
**GLIPIZIDE:** Purpose
Management of type 2 diabetes
37
**GLIMEPIRIDE:** Nursing Considerations
* ***Do not drink alcohol since it may produce a disulfiram reaction:*** nausea, headache, cramps, flushing, hypoglycemia * A***ssess for symptoms of cholestatic jaundice:*** dark urine, pruritus, yellow sclera (rare) * Take at breakfast or first main meal; onset 1–1.5 hours, peak 1–3 hours, duration 10–24 hours * Have a quick source of sugar or a glucagon emergency kit available * Do not crush, chew, or break extended-release tablet * ***Cross allergy possible if allergic to sulfonamide*** * Monitor blood sugars * Wear medical information tag * Rx; Preg Cat C
38
**GLIMEPIRIDE:** Side Effects
* Headache * Weakness, dizziness * Drowsiness * Photosensitivity * Hepatotoxicity * Cholestatic jaundice * Increased liver enzymes
39
**GLIMEPIRIDE:** Purpose
Management of type 2 diabetes
40
**ACARBOSE:** Nursing Considerations
* ***Used alone or in combination with a sulfonylurea or insulin*** * PO: take with first bite of each meal, med blood level peaks in 1 hour * Recognize signs of hypoglycemia: weakness, hunger, dizziness, tremors, anxiety, tachycardia, hunger, sweating * Measure short-term effectiveness with blood sugar 1 hour after meals * Measure long-term effectiveness with glycosylated Hgb every 3 months for the first year * Wear medical information tag * Rx; Preg Cat B
41
**ACARBOSE:** Side effects
* Abdominal pain * Diarrhea * Flatulence
42
**ACARBOSE:** Purpose
Management of type 2 diabetes
43
**EXENATIDE:** Nursing Considerations
* subQ: give extended-release product once weekly without regard to food; give immediate-release product twice daily 30 minutes before a meal * Extended-release version requires reconstitution just before administration * Both products are refrigerated before use * Do not use in patients with severe renal impairment or history of pancreatitis * Routinely monitor blood glucose * Rx; Preg Cat C
44
**EXENATIDE:** Side Effects
* Nausea, vomiting, diarrhea * Constipation * Injection site reactions * Hypoglycemia * Pancreatitis * Headache * Dizziness * Decreased appetite/weight loss * Gastroesophageal reflux
45
**EXENATIDE:** Purpose
Management of type 2 diabetes

Pharmacology - NCLEX (20 decks)

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