Oral Antidiabetic Agents Flashcards
5 types of oral antidiabetic agents
- Sulfonylureas
2.Biguanides - Alpha-glucosidase
- Glitazones
- Meglitinide
Example of Biguanides
metformin
(Glucophage-trade name)
MOA if Biguanides
-Act on liver to reduce release of glycogen and increase cell sensitivity to insulin
- Reduce absorption of glucose from intestinal tract
Side effects of Biguanides
-Flatulence
-Diarrhea
-Dizziness
Anorexia
Adverse effects of biguanides
-Lactic acidosis
-Megaloblastic anemia
Why does metformin need to be DC 48hrs prior and after diagnostic tests using contrast die?
to prevent renal failure, since both will be competing in the kidney
Examples of Sulfonylureas
-glimepiride (Amaryl)
-glyburide (Diabeta)
-glipizide (Glucotrol)
MOA of Sulfonylureas
-trigger pancreatic beta cells to release small amounts of insulin and increase sensitivity to insulin
Side effects of Sulfonylureas
-Hypoglycemia
-Diarrhea
-dizziness
-tremor
-rash
Adverse effects of Sulsfonylureas
- aplastic anemia (stop making BC)
-leukopenia (decrease WBC)
-Jaundice
-Pancytopenia (decrease RBS, WBC, and platelets
nursing considerations in Sulfonylureas
-check BS can cause hypoglycemia
- only given po
Alpha-glucosidase inhibitor examples
- acarbose (Precose)
- miglitol (Glycet)
MOA of Alpha-glusodiase
- inhibits the enzyme that breaks carbs down to glucose in the GI tract
Side effects of Alpha-glucosidase
- flatulence
- diarrhea
- abdominal pain
-LFT’s elevated
Adverse effects of Alpha-glucosidase
-ileus
- hepatitis
- thrombocytopenia
- jaundice
- pancytopenia
Nursing conditions for Alpha-glucosidase deficiency
- does not cause hypoglycemia
- only given po
- take with 1st meal bite, 3x/day
Examples of Meglitinides
repaglinide (Prandin)
MOA of Meglitinides
- stimulate brief burst-like release of insulin (30-60 min)
Side effects of Meglitinides
- URI (upper respiratory infection)
- hypoglycemia
- HA (headache)
- Arthralgia (joint pain)
- chest pain
Adverse effects of Meglitinides
- S-J syndrome (auto immune disorder)
- myocardial ischemia (prevent blood flow to heart)
- leukopenia
Examples of Glitazones
- pioglitazone (Actos)
- rosiglitazone (Avandia)
MAO for Glitazone
- increase cell sensitivity to insulin
- act on liver to reduce release of glucose from stored glycogen
side effects of Glitazones
- URI
- weight gain
- edema
- fluid retention
- HA (head ache)
- anemia
Adverse effects of Glitazone
-CHF (congestive heart failure)
- hepatotoxicity
- diabetic macular edema
- bladder cancer risk
nursing considerations for Glitazones
- monitor liver function frequently
- cannot use if client has liver disease
Can type 1 diabetic use oral agents and why?
No, because they need to have a functioning pancreas
