Oral Hypoglycemics Flashcards
What are some Sulfonylureas?
Glipizides (2nd Generation)
Tolbutimides (1st Generation)
What are some things to consider when taking Sulfonylureas?
- Carry some form of sugar (e.g. candy, chewing gum) with you or be close to a place with access to food
- Do not give 48 hours prior to delivering a baby to prevent hypoglycemia of the newborn
- Avoid Alcohol (Sugar)
What do Sulfonylureas do?
Makes the pancreas to produce insulin
What are some Metigilinides?
Rapaglinides
Nateglinides
What are some considerations of Metiglinides?
- Patients on Sulfonylureas will not respond to Meglinitides
What do you do if you miss a meal or add a meal when taking Rapaglinides or Nateglinides?
- Skip a dose or add a dose respectively
- Do not exeed 4 doses a day
What are some Biguanides?
Metformin
What does Metformin do?
- Decrease the amount of insulin absorbed in the intestines
- Decrease the amount of glucose produced by the liver
- Increase insulin receptor sensitivity
What do Metiglinides (Rapaglinide and Nateglinides) do?
Stimulates the pancreas to produce insulin
What are some deficiencies you have to worry about when taking metformin?
Vitamin B12 and Folic Acid Deficiency
A patient on metformin needs to get a CT scan. What should you as the nurse do and why?
You should discontinue Metformin 24-48 hours before any labs or test that involve contrast dye because it might cause liver failure.
What are some things to teach your patients that are on oral hypoglycemics?
- How to check their blood sugar
- Carry a carbohydrate snack with them
- Wear a medic alert bracelet
- How to recognize the signs and symptoms of hypoglycemia
- Follow diet prescribed by healthcare provider
What is a side effect of metformin and why does it occur?
Dumping Syndrome (Diarrhea, Flatus, and Abdominal Distention) - occurs because sugars stay in the stomach and the body wants to get rid of it
What do pioglitizones do?
Reduce insulin resistance in tissues
What are some considerations when taking pioglitizones?
- Needs insulin to work
- If nothing else works, then use this
- Can cause hepatotoxicity
What are some things to teach your patient about pioglitizones?
- Look for signs of hepatotoxicity and stop if it occurs (i.e. Jaundice)
What are some Alpha-Glucosidase Inhibitors?
Arcabose
Miglitol
What do Arcabose and Miglitol do?
Inhibits breakdown of carbs in the intestines
What are some side effects of Arcabose and Miglitol?
Diarrhea, Flatus, Abdominal Distention
What are some nursing considerations when taking Arcabose and Miglitol?
- There is a risk for hypoglycemia
- Can cause hepatotoxicity
What are some things patients should know about Arcabose and Miglitol?
- Take with the FIRST BITE of FOOD three times a day
- Use Glucagon Gel Tabs to reverse effects of severe hypoglycemia because carbohydrate exchanges ALONE doesn’t work
- Know signs of heart attack such as Chest Pain
What are some examples of Gliptins?
Sitagliptin (Januvia)
What does Sitagliptin (januvia) do?
- Augment Incretin (Insulin Up and Glucose Down) hormone
- Promotes the release of Insulin
- Decrease the secretion of glucagon
What are some adverse effects of Sitagliptins (Januvia)?
- Pancreatitis
- Upper respiratory tract infection
