endocrine: oral antidiabetics Flashcards
oral antidiabetics moa
Sulfonylureas: insulin release from pancreas: can increase tissue sensitivity to insulin over time
biguanides: reduce the production of glucose within the liver through suppression of glucoengenesis, increase glucose uptake and use in fat and skeletal muscle, decrease glucose absorption in the GI tract (1st choice for type 2 diabetes)
oral antidiabetics therapeutic uses
control of blood glucose levels in clients that have type 2 diabetes
oral antidiabetics common meds (sulfonyluras)
- chlorpropamide
- glipizide
- tolazamide
- glyburide
- glimepiride
oral antidiabetics common meds (biguanides)
metformin
oral antidiabetics complications (sulfonylureas)
hypoglycemia
weight gain
oral antidiabetics complications (biguanides)
- gi effects (n,d, anorexia)
- vitamin b12 and folic acid deficiency
- lactic acidosis
oral antidiabetics contraindications
- caution in renal failure, hepatic dysfunction, heart failure (risk of med accumulation and causing hypoclycemia)
- diabetic ketoacidosis (DKA)
oral antidiabetics ineractions
- alcohol
- NSAIDS, sulfonamides, ranitidine, cimeitide = additive hypoglycemic effect)
- beta blockers (decrease effectiveness)
- iodine- containing contrats (with metformin)
oral antidiabetics nursing implications
- give diabetic education
- glipizide should be taken 30 min before breakfast- hold if pt. not able to eat
- metformin- have pt. take immediate release tabs 2x per day with breakfast and dinner and sustained release tabs once daily with dinner
- check blood sugar on a regular basis
oral antidiabetics patient teaching
- diabetic education
- excerise consistently and follow appropriate dietary guidlines
- maintain a log of glucose levels and note patterns that affect glucose levels ( diet, infection)
- formulations can combine two medications
- if also taking insulin, monitor for hypoglycemia
