UNIT 9 ORAL ANTIDIABETIC MEDICATIONS CHAPTER 50: Sulfonylurea- Glipizide, Biguanide- Metformin, Incretin mimetics-Exenatide, Hyperglycemic Hormone- Glucagon

Question 1

What is Diabetes? What are the signs of Symptoms

Answer 1

Chronic disease of deficient glucose
metabolism
 Insufficient insulin secretion from beta
cells
 Impaired insulin use
 Major symptoms: polyuria, polydipsia,
polyphagia

Question 2

How many types of Insulin are there, and what does it represent?

Answer 2

Types
 Type 1
 Insulin-dependent DM
 Type 2
 Insulin resistant
 Secondary
 Due to medications (glucocorticoids, thiazide
diuretics, epinephrine)
 Gestational
 Due to hormonal changes
DIABETES

Question 3

What drug class is the drug Glipizide?

A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. NSAID

Answer 3

B. Sulfonylureas

Question 4

What is the drug action of Glipizide?

Answer 4

Used to treat type 2 diabetes

Action (increases insulin)
Stimulate pancreatic beta cells to secrete more
insulin
Decrease glucose production
Makes cells more receptive to insulin

*STIMULATES BETA CELLS TO PRODUCE MORE INSULIN TO REGULATE GLUCOSE LEVELS

Question 5

What is a side effect of Glipizide?

Answer 5

 Side Effects
 Drowsiness, headache, confusion, visual disturbances, GI disturbances, anxiety

Question 6

What is a adverse effect of Glipizide

Answer 6

 Adverse Reactions
 Hypoglycemia, tachycardia
 Seizures, coma respiratory depression

Question 7

Should you use Glipizide with Beta 2 blockers ?

A. Yes
B. No

Answer 7

Interactions
 Alcohol – Antabuse type reaction
 Beta blockers
 Green tea – increases hypoglycemia
 Many other

Question 8

Should you use Glipize for a pt with kidney or Liver failure ?

A. Yes
B. No

Answer 8

B. No

Contraindications
 Liver or kidney dysfunction

Question 9

What drug class is Metformin?

A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. NSAID

Answer 9

A. Biguanides

Question 10

What is the action of Metformin?

Answer 10

Uses
 Control blood sugar in type 2 diabetes
* Action (decreases sugar)
 Decrease hepatic production of glucose from stored
glycogen
 Diminishes increase in serum glucose after meals
 Decreases postprandial hyperglycemia
 Decreases glucose absorption from small intestine
 Increases insulin receptor sensitivity
 Increases peripheral glucose uptake at the cellular level

Question 11

Side effects of Metformin

Answer 11

Side effects
 Dizziness, fatigue, headache
 Agitation
 Bitter or metallic taste
 Weight loss
 GI symptoms – abdominal pain, bloating, discomfort

Question 12

Adverse Effect of Metformin

Answer 12

Adverse Reactions
 Hypoglycemia (not as common)
 Lactic acidosis

Question 13

Should you hold metformin before a pt receives contrast dye for a procedure?

A. No
B. Yes

Answer 13

B. Yes

Contraindications
 Hold medication 48 hours before and after pat receives
contrast dye or patient may have lactic acidosis or
acute renal failure
 Hepatic/renal dysfunction
 Interactions
 Many
 IV contrast dye
 Green tea increases hypoglycemia
 Can cause liver dysfunction

Question 14

What drug class is Exentinide?

A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. Incretin mimetics

Answer 14

D. Incretin mimetics

Question 15

What is the action of Exentinide?

Answer 15

Increntine Hormone- regulate the amount of insulin that is secreted after eating

Actions
 . Increase the level of incretin hormones
 Increase insulin secretion
 Decrease glucagon secretion to reduce glucose production

DOES NOT REPLACE INSULIN

Not a substitute for insulin
For type 2 diabetes

Side effects similar to oral hypoglycemic

Administered SUBQ twice a day helps decrease A1C

Question 16

Assessment for Exentidine

Answer 16

Assessment
 Medication/medical history
 Alcohol intake
 Vital signs
 Blood glucose, A1C
 Patient’s knowledge of disease, meds
 Kidney/liver function

Interventions
 VS, cardiac status
 Administer with food
 Monitor blood glucose, liver, kidney function
 Monitor for side effects, adverse reactions
 Prepare a teaching plan

Question 17

Patient Teaching for oral diabetics

Answer 17

Teaching
 Signs and symptoms of hypoglycemia, how to prevent and how
to stop hypoglycemic episode
 Insulin can be used as well when stress, surgery, meds
 Diet and exercise
 Medic alert tag
 Teach how to monitor blood glucose
 No alcohol
 Eat on schedule
 Take with food to minimize stomach upset

Question 18

What is the drug class for Glucagon?

Answer 18

Hyperglycemic Hormone

Question 19

What is the action of glucagon?

Answer 19

 Hyperglycemic hormone secreted by the alpha
cells of the islets of Langerhans
 Increases blood sugar by stimulating glycogenolysis in liver
 Use
 Used to treat insulin-induced hypoglycemia when other
methods of providing glucose are not available or patient non-
responsive
 Route of administration
 Parenteral use (subQ, IM, and IV)
 Works in about 10 minutes

Question 20

A patient is prescribed metformin. Which is
a side effect/adverse effect common to
metformin?
A. Seizures
B. Constipation
C. Bitter or metallic taste
D. Polyuria and polydipsia

Answer 20

Answer: C
Rationale: Metformin has a bitter or metallic taste. Seizures,
constipation, polyuria, and polydipsia are not side
effects/adverse effects of metformin.