NUR 144 - Diabetes Med List

Question 1

Alpha Glucosidase Inhibitors

Precose (acarbose)

Mechanism of action
Side effects
Nursing implications

Answer 1

Mechanism:
- Delays absorption of complex carbs = slow entry of glucose into bloodstream
- Leads to decreased Hgb A1c

Side effects:
- Hypoglycemia
- GI side effects
- Liver toxicity

Nursing Implications
- Take with first bite
- Monitor Liver Function Tests (LFTs)

Question 2

Class: Biguanides

Glucophage (metformin):

Mechanism of action
Beneficial features
Side effects
Contraindications

Answer 2

Mechanism:
- Inhibits production of glucose by liver
- Increase tissue sensitivity to insulin = increased insulin uptake
- decreased hepatic synthesis of cholesterol

Beneficial features:
- Improved glycemic conrol in most patients
- Does not cause hypoglycemia if used alone
- Weight loss

Side effects:
- GI side effects
- Lactic acidosis

Contraindications:
- Renal dysfunction
- Liver dysfunction
- Alcohol abuse
- Congestive Heart Failure (CHF)

Question 3

Dipeptidyl Peptidase-4 (DPP-4) Inhibitors

Januvia (sitagliptin):

Mechanism of action
Side effects
Nursing implication

Answer 3

Mechanism:
- Prolongs the action of incretin
- Results in improved glucose control

Side effects:
- Frequency URIs
- Headache
- GI side effects
- Hypoglycemia if combined with sulfonylurea

Nursing implication:
- Monitor and educate about s/s of hypoglycemia

Question 4

Glucagonlike Peptide-1 Agonist

Trulicity (Dulaglutide):

Mechanism of action
Side effects

Answer 4

Given 1x a week as subQ injection

Mechanism of action:
- Enhances glucose dependent insulin secretion
- Incretin mimetic

Side effects:
- Pancreatitis
- Weight loss
- GI effects

Question 5

Glucagonlike Peptide-1 Agonist

Ozempic (semaglutide)

Answer 5

Side effects:
- Pancreatitis
- GI symptoms
- Weight loss

Not recommended as first line in patients with poor glycemic control

Contraindicated = patients with hx of thyroid cancer

Question 6

Mounjaro (tirzepatide)

Side effects
Contraindicated

Answer 6

Side effects:
- Pancreatitis
- GI symptoms
- Weight loss
- Hypoglycemia

Contraindication = pts with hx of thyroid cancer

1xweek subQ

Question 7

2nd Gen Sulfonylureas

Glucotrol (glipizide), Diabeta (glyburide), Amaryl (glimepiride):

Mechanism of action
Side effects

Answer 7

Mechanism:
- Stimulate beta cells to secrete insulin
- May improve insulin’s ability to bind receptors on cell membrane: improved sensitivity

Side effects:
- Hypoglycemia
- GI symptoms
- Weight gain
- Potential interaction with many common drugs