Oral Hypoglycemics

Question 1

What are some Sulfonylureas?

Answer 1

Glipizides (2nd Generation)

Tolbutimides (1st Generation)

Question 2

What are some things to consider when taking Sulfonylureas?

Answer 2

• 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)

Question 3

What do Sulfonylureas do?

Answer 3

Makes the pancreas to produce insulin

Question 4

What are some Metigilinides?

Answer 4

Rapaglinides

Nateglinides

Question 5

What are some considerations of Metiglinides?

Answer 5

• Patients on Sulfonylureas will not respond to Meglinitides

Question 6

What do you do if you miss a meal or add a meal when taking Rapaglinides or Nateglinides?

Answer 6

• Skip a dose or add a dose respectively

- Do not exeed 4 doses a day

Question 7

What are some Biguanides?

Answer 7

Metformin

Question 8

What does Metformin do?

Answer 8

• Decrease the amount of insulin absorbed in the intestines
• Decrease the amount of glucose produced by the liver
• Increase insulin receptor sensitivity

Question 9

What do Metiglinides (Rapaglinide and Nateglinides) do?

Answer 9

Stimulates the pancreas to produce insulin

Question 10

What are some deficiencies you have to worry about when taking metformin?

Answer 10

Vitamin B12 and Folic Acid Deficiency

Question 11

A patient on metformin needs to get a CT scan. What should you as the nurse do and why?

Answer 11

You should discontinue Metformin 24-48 hours before any labs or test that involve contrast dye because it might cause liver failure.

Question 12

What are some things to teach your patients that are on oral hypoglycemics?

Answer 12

• 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

Question 13

What is a side effect of metformin and why does it occur?

Answer 13

Dumping Syndrome (Diarrhea, Flatus, and Abdominal Distention)
- occurs because sugars stay in the stomach and the body wants to get rid of it

Question 14

What do pioglitizones do?

Answer 14

Reduce insulin resistance in tissues

Question 15

What are some considerations when taking pioglitizones?

Answer 15

• Needs insulin to work
• If nothing else works, then use this
• Can cause hepatotoxicity

Question 16

What are some things to teach your patient about pioglitizones?

Answer 16

• Look for signs of hepatotoxicity and stop if it occurs (i.e. Jaundice)

Question 17

What are some Alpha-Glucosidase Inhibitors?

Answer 17

Arcabose

Miglitol

Question 18

What do Arcabose and Miglitol do?

Answer 18

Inhibits breakdown of carbs in the intestines

Question 19

What are some side effects of Arcabose and Miglitol?

Answer 19

Diarrhea, Flatus, Abdominal Distention

Question 20

What are some nursing considerations when taking Arcabose and Miglitol?

Answer 20

• There is a risk for hypoglycemia

- Can cause hepatotoxicity

Question 21

What are some things patients should know about Arcabose and Miglitol?

Answer 21

• 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

Question 22

What are some examples of Gliptins?

Answer 22

Sitagliptin (Januvia)

Question 23

What does Sitagliptin (januvia) do?

Answer 23

• Augment Incretin (Insulin Up and Glucose Down) hormone
• Promotes the release of Insulin
• Decrease the secretion of glucagon

Question 24

What are some adverse effects of Sitagliptins (Januvia)?

Answer 24

• Pancreatitis

- Upper respiratory tract infection