Oral antidiabetic drugs Flashcards
There are 5 (five) classes of oral antidiabetic drugs, which class is Metformin ?
Biguanides
What is a second generation Sulfonylureas ordered frequently? Think 3 Gs
Glipizide, Glyburide, Glimepiride
What is the expected pharmacological action of the Sulfonylureas group?
- Insulin release from the pancreas; over time it can increase tissue sensitivity to insulin
What is the therapeutic use of oral antidiabetics?
Control blood glucose levels in clients who have type 2 diabetes used in conjunction with diet & exercise
What is the pharmacological action for the Meglitinides group of drugs?
- Insulin release from the pancreas
What is the first-choice group oral antidiabetic medication for clients who have type 2 diabetes?
Biguanides- Metformin
Which group of oral antidiabetic medications reduces the production of glucose within the liver?
Biguanides-
Which group of oral antidiabetic medications is particularly effective for clients of Latino or African heritage in clinical trials?
Alpha-glucosidase inhibitors-prototype - Miglitol
What is the pharmacological action for a Sodium-glucose co-transporter 2 (SGLT-2) inhibitors?
- Used in combination with insulin for type 1 dm, * limits the rise of glucose postprandial (means after a meal) excretes glucose through the urine by preventing its reabsorption in the kidney, promotes weight loss
What is the other use for Metformin?
Polycystic ovary syndrome (PCOS) (off label use
Which group of oral antidiabetic medications augments naturally occurring incretin hormones (are gut hormones which regulate the amount of insulin that is secreted after eating), which promote release of insulin and decrease secretion of glucagon?
Dipeptidyl peptidase-4 (DPP-40 inhibitors) the prototype is Sitagliptin
What are adverse effects or complications with Glipizide and repaglinide?
Hypoglycemia and weight gain
What are adverse effects or complications with Metformin?
GI (anorexia, nausea & diarrhea) ,Vit B12 & folic acid deficiency, Lactic acidosis,
What are symptoms of Lactic acidosis? How would the client present?
Complaints of myalgic, pain & sluggishness, somnolence - *** there is a 50% mortality rate
How is severe Lactic acidosis? treated ?
Hemodialysis (HD)
True or False, All oral antidiabetic medications are contraindicated in the treatment of DKA?
True
What are two visible signs of hepatotoxicity ?
Dark urine & or jaundice
What are contraindications/precautions for oral antidiabetic medications?
DKA, Renal Failure, Hepatic dysfunction, or HF
Why use cautiously in clients with HF ?
Because of the risk of medication accumulation which can result in hypoglycemia
Which oral antidiabetic medications drug is contraindicated for patients who have severe infections, shock, kidney impairment, and any hypoxic condition?
Metformin
Which oral antidiabetic medication is contraindicated for clients with GI disorders, UC& IBD ?
Acarbose an (Alpha-glucosidase inhibitor)
What oral antidiabetic medication is contraindicated who has RF and are undergoing dialysis?
Canagliflozin
True or False, Sitagliptin should only be used during pregnancy if clearly indicated, excretion of Sitagliptin is unknown in breast milk?
True
ETOH is an interaction for Glipizide & Metformin, True or False?
True
NSAIDs, sulfonamide antibiotics, ranitidine & cimetidine has an additive hyperglycemic effect with Glipizide and Pioglitazone, True or False
False it causes hypoglycemia
Concurrent use of phenytoin, rifampin, and phenobarbital has a decreased effect with which oral antidiabetic medication?
Canagliflozin (Sodium-glucose co-transporter 2 (SGLT-2) inhibitors
What is the emergency management agent with the expected pharmacological action to increase blood glucose by increasing the breakdown of glycogen into glucose?
Glucagon
What are the adverse effects or complications of Glucagon?
GI distress (N&V) aspiration
What is a contraindication of Glucagon?
Might not be effective for hypoglycemia resulting from inadequate glycogen stores, hence starvation
What are the routes of administration of Glucagon?
Sub -Q, IM or IV
How can a nurse evaluate the effectiveness of glucagon?
Elevation in the blood glucose level to greater than 70 mg/dL
