Diabetic medications (glucagonlike peptide- 1 receptor agonists, hypoglycemic agents -oral, insulin, reversal of hypoglycemia) Flashcards
Exenatide
glucagonlike peptide-1 receptor agonists
purpose: management of type 2 diabetes
Nurs con: - SubQ: give extended-release product once weekly without regard to food; give immediate-release product twice daily 30 minutes before a meal
- both products refrigerated before use
- do not use in patients with severe renal impairment or history of pancreatitis
Acarbose
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: -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 hyopglycemia; weakness, hunger, dizziness, tremors, anxiety, tachycardia, 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
Glimepiride
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: -do not drink alcohol since it may produce a disulfiram reaction: nausea, headache, cramps, flushing, hypoglycemia
- asses 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 of glucagon emergency kit available
- cross allergy possible if allergic to sulfonamide
Glipizide
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: -do not drink alcohol since it may produce a disulfiram reaction: nausea, headache, cramps, flushing, hypoglycemia
- asses 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 min before meals, since absorption is delayed by food
- have quick source of sugar or glucagon emergency kit available
- may cause hemolytic anemia when used with sulfonylurea agents
Glyburide
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: -asses 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 glucagon emergency kit availble
metformin HCL
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: PO: twice a day with meals to decrease GI upset and provide best absorption; may also be taken as one dose
- can crush tablets & mix with juice or soft foods for ease of swallowing
- do not crush, chew or break extended release
- be aware of signs of lactic acidosis; hyperventilation, fatigue, malaise, chills, myalgia, sleepiness
- have quick source of sugar or glucagon emergency kit available
Pioglitazone HCL
Hypoglycemic Agents, Oral
purpose: management of type 2 diabetes
Nurs con: -take around the same time each day, once daily with or without food
- full therapeutic effects may require 2 weeks or more weeks
- may exacerbate CHF; monitor for edema & lung sounds
Rosiglitazone Maleate
Hypoglycemic agents, oral
purpose: management of type 2 diabetes
Nurs con: PO: once a day or in 2 individual doses
- take without regard to meals
- have quick source of sugar or glucagon emergency kit available
Stiagliptin
Hypoglycemic agents, oral
purpose: management of type 2 diabetes as mono therapy or in combination with other anti diabetic agents
Nurs con: -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
Insulin aspart
Insulin
purpose: management of diabetes
Nurs con: -the only insulin analog approved for use in external pump systems for continuous subQ insulin infusion
- onset 15 minutes, peak 1-3 hours, duration 3-5 hours
- may be administered IV in emergency situations under medical supervision with close blood-sugar monitoring
- immediately follow injection with meal within 5-10 minutes
Insulin glargine
Insulin
purpose: management of diabetes
Nurs con:
- 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
- do not admin IV or via insulin pump
- DO not mix with other insulin
Insulin-Isophane suspension (NPH)
Insulin
purpose: management of diabetes
Nurs con: -comes in 100 unit per ml vial as well as in combination with regular insulin in a 50/50 proportion and 75/25 proportion
SUB Q: onset 1-1.5 hours, peak 4-12 hours, duration 18-24 hours
-read admin instructions carefully
-do not give IV
Insulin Lispro
Insulin
purpose: management of diabetes
Nurs con: -Take withing 15 minutes of eating & immediately after mixing with combined therapy
- may be used in children in combination with sulfonylureas
- onset rapid, peak 30-90 minutes, duration 6-8 hours
- may be used in an external insulin pump
- monitor blood sugar
- may be administered IV in emergency situations under medical supervision with close blood-sugar monitoring
- if administered using insulin pen read instructions carefully
- do not mix with other insulins
- available in combination with other insulin
Insulin regular
insulin
purpose: management of diabetes
Nurs con: -only insulin that can be given IV in non-emergency situations
- SQ onset 30-60 min, peak 2-3 hours, duration 3-6 hours
- IV: onset 10-30 minutes, peak 10-30 minutes, duration 30-60 minutes
- may be mixed with NPH only in same syringe draw regular insulin first
- do not use in insulin pumps
Glugacon
reversal of hypoglycemia
purpose: acute management of hypoglycemia, facilitation of diagnostic tests through temporary inhibition of GI tract movement
Nurs con: -IV: onset immediate, peak 30 minutes, duration 60-90 minutes
- SQ: onset within 10 minutes, peak 13-20 minutes, duration 30 minutes
- monitor blood sugar until patient is asymptomatic
- use reconstituted mixture within 15 minutes of mix
