Glucose Regulation Medications Flashcards
Metformin
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,
Glyburide
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,
Metformin SE/AE and Education
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,
Glyburide SE/AE and Education
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.
Pioglitazone
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,
Pioglitazone SE/AE and Education
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,
Repaglinide
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
Repaglinide SE/AE and Education
PO, chest pain, hypoglycemia, check blood sugar regularly, diet and exercise, give before meals, usually well tolerated
Acarbose
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,
Acarbose SE/AE and Education
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
Sitagliptin
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,
Sitagliptin SE/AE and Education
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
Empagliflozin
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
Empagliflozin SE/AE and Education
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
Exenatide
adjunct to diet and exercise in T2DM, slows gastric empyting, stimualtes glucose dependent release of insulin, inhibits postprandial release of glucagon and suppresses appetite,
Exenatide SE/AE and Education
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
Semaglutide
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,
Semaglutide SE/AE and Education
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.
Regular Insulin
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
Insulin Lispro
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
NPH Insulin
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
Insulin Glargine
modified human insulin; ***onset 3-4 hr, peak none, duration up to 24 hr given once per day; long duration; NEVER give IV
Insulin Degludex
has solubles that slows absorption; ** onset 2hr, peark 12 hr, duration up to 42 hr; give once daily DO NOT mix or give IV*
