Glucose Regulation Medications

Question 1

Metformin

Answer 1

management of type 2 diabetes; used in combo with good diet, insulin, or sulfanylurea oral hypoglycemics, decreases hepatic glucose production, decreases intestinal glucose absorption, increases sensitivity to insulin,

Question 2

Glyburide

Answer 2

control blood sugar in T2DM when diet therapy is not working, first antidiabetic medication available, lowers BG by stimulating insulin to be secreted by pancreas, increases sensitivity to insulin receptor sites, may decrease hepatic glucose production,

Question 3

Metformin SE/AE and Education

Answer 3

PO, lactic acidosis, GI upset, do not consume alcohol, diet and exersise is important, renal function tests during long term use, take at the same time daily,

Question 4

Glyburide SE/AE and Education

Answer 4

PO, erythema multiforme!!!, photosensitivity, aplastic anemia, weight gain, hypoglycemia, cardiotoxicity, do not consume alcohol, monitor weight and CBC with long term use, take at same time daily check BG, follow diet and exericise, avoid aspirin, use sunscreen.

Question 5

Pioglitazone

Answer 5

control blood sugar in T2DM, may use with metformin, sulfonylureas or insulin; improves sensitivity to insulin by acting as an agonist at receptor sites and also glucose production and use, requires presence of insulin for activity, decreases insulin resistance without hypoglycemia,

Question 6

Pioglitazone SE/AE and Education

Answer 6

PO, heart failure!!, liver failure!!, bladder cancer!!, rhabdomyolysis!!, URI, sinusitis, headache, myalgia, signs of heart failure, monitor CBC and liver enzymes with long term use, take at same time daily, follow diet and exercise, give with or without food,

Question 7

Repaglinide

Answer 7

control blood sugar in T2DM, may be used with metformin, rosiglitazone or pioglitazone, stimulates insulin to release by closing the potassium channels, opens calcium channels in beta cells to release insulin

Question 8

Repaglinide SE/AE and Education

Answer 8

PO, chest pain, hypoglycemia, check blood sugar regularly, diet and exercise, give before meals, usually well tolerated

Question 9

Acarbose

Answer 9

management of blood sugar in T2DM, may use with insulin or other hypoglycemic agents, lower blood sugar by inhibiting the enzyme alpha-glucosidase in the GI tract, delays and reduced glucose absorption, especially helpful in postprandial hyperglycemia,

Question 10

Acarbose SE/AE and Education

Answer 10

PO, GI upset, liver dysfunction, hypoglycemia, check blood sugar regularly, monitor liver enzymes, give with first bite of each meal 3/day, give at same time daily, diet/excersise

Question 11

Sitagliptin

Answer 11

as an adjunst to diet and exercise in T2DM blood sugar management, promotes glycemic control by enhancing the actions of incretin hormones, stimulates glucose dependent release of insulin, suppress postprandial release of glucagon,

Question 12

Sitagliptin SE/AE and Education

Answer 12

PO, SJS, pancreatisis!!, rhabdomyolysis!!, GI upset, heart failure, monitor for signs of pancreatitis, assess for SJS rashes, monitor renal function, given with or without food, diet /exercise, monitor BG

Question 13

Empagliflozin

Answer 13

adjunct to diet and exercise in T2DM, reduce risk of CV death in T2DM with CV disease, reduce risk of CV death and hospitilizations for HF in pt with HF, blocks reabsorption of filtered glucose in the kidney, leading to glucosuria, increases excretion of glucose in urine

Question 14

Empagliflozin SE/AE and Education

Answer 14

ketoacidosis!!, necrotizing fasciitis of perineum!!, urosepsis!!, gential fungal infections in females, UTI, polyuria, assess signs of dehydration, monitor UOP, give at the same time daily with or without food, follow diet/exercise, assess skin for ulcers and sores, assess for yeast in females

Question 15

Exenatide

Answer 15

adjunct to diet and exercise in T2DM, slows gastric empyting, stimualtes glucose dependent release of insulin, inhibits postprandial release of glucagon and suppresses appetite,

Question 16

Exenatide SE/AE and Education

Answer 16

thyroid C cell tumors!!, pancreatitis!!, thrombocytopenia!!, decreased appetite, weight loss, CNS changes, asses for s/s of pancreatitis, monitor renal function, take 60 min before meals, proper inj techniques, follow diet/excersie

Question 17

Semaglutide

Answer 17

adjunct to diet and exercise in T2DM, reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes and established CV disease; slows gastric emptying stimulates glucose dependent release of insulin, inhibits postprandial release of glucagon and suppresses appetie,

Question 18

Semaglutide SE/AE and Education

Answer 18

SQ, also comes in PO, thyroid c cell tumors!!, pancreatitis!!, abdominal pain, constipation, n/v/d, decreased appetite, weight loss tachycardia, assess for s/s of pancreatitis, monitor a1c, monitor hr, proper inj techniques, diet/excersise.

Question 19

Regular Insulin

Answer 19

unmodified human insulin; do not take if hypoglycemic, do not drink alcohol, short duration, slower acting; onset-30-60min, peak- 1-5 hr, duration up to 10 hr not as rapid as lispro

Question 20

Insulin Lispro

Answer 20

analog of regular insulin; do not take if hypoglycemic , do not drink alcohol; *short duration, rapid acting; onset 30 min, peak 30-2.5 hr, duration 3-6hr; acts faster than regular insulin but a shorter duration of action, give 5-10 mins before meals

Question 21

NPH Insulin

Answer 21

insulin + protamine (decreases solubility and makes it cloudy), inject 2-3 times daily to control between meals and at night; *onset 2-4 hr, peak 4-10 hrs, duration up to 24; intermediate duration only one that can be mixed with short acting and subQ ONLY

Question 22

Insulin Glargine

Answer 22

modified human insulin; ***onset 3-4 hr, peak none, duration up to 24 hr given once per day; long duration; NEVER give IV

Question 23

Insulin Degludex

Answer 23

has solubles that slows absorption; ** onset 2hr, peark 12 hr, duration up to 42 hr; give once daily DO NOT mix or give IV*