Hypoglycemic Agents

Question 1

GLUCAGON

Answer 1

MoA: stim liver to Δ glycogen → glucose to reverse hypoglycemia

SE: ↓ BP, bronchospasm, dizzy

NC:

• may repeat in 15 min
• failure to respond → admin IV Glucose
• give carbs PO when pt awake to prevent secondary hypoglycemic rxn

Question 2

SULFONYLUREAS (3)

GGG

Answer 2

Glyburide, Glipizide, Glimepride

T2 DM - stim release of insulin from pancreas

SE: GI s/sx, dermatologic rxn

NC:

• W/ FOOD (d/t GI upset)
• ∅ sulfa allergy (sulfonamide)

Question 3

BIGUANIDE

Metformin

Answer 3

T2 DM - ↓ glucose production by liver, ↑ sensitivity of insulin

SE: N/D, lactic acidosis (abd discomfort)

NC: ∅ alpha-glucosidase inhibitors, alcohol

Question 4

ALPHA-GLUCOSIDASE INHIBITOR

Acarbose

Answer 4

T1 or T2 - delays digestion of carbs

SE: abd discomfort, D (gas)

NC - admin immediately BEFORE meal

Question 5

THIAZOLIDINEDIONES

Answer 5

“-glitazone” - Rosiglitazone, Proglitazone

T2 DM - ↓ insulin resistance, & inhibit gluconeogenesis

SE: infection, HA, pain, liver failure

NC:

• Monitor liver func tests
• BBW = hepatotoxicity

Question 6

MEGLITINIDES

Answer 6

“-glinide” - Repaglinide

T2 DM - stim insulin release from pancreas

SE: hypoglycemia, GI upset, URIs, HA

NC: do NOT take if skip meal

Question 7

GLIPTINS

Answer 7

“-gliptin” - Sitagliptin

T2 DM - enhance increin hormone (glucagon-like hormone)

SE: URIs , hypoglycemia