UNIT 9 ORAL ANTIDIABETIC MEDICATIONS CHAPTER 50: Sulfonylurea- Glipizide, Biguanide- Metformin, Incretin mimetics-Exenatide, Hyperglycemic Hormone- Glucagon Flashcards
What is Diabetes? What are the signs of Symptoms
Chronic disease of deficient glucose
metabolism
Insufficient insulin secretion from beta
cells
Impaired insulin use
Major symptoms: polyuria, polydipsia,
polyphagia
How many types of Insulin are there, and what does it represent?
Types
Type 1
Insulin-dependent DM
Type 2
Insulin resistant
Secondary
Due to medications (glucocorticoids, thiazide
diuretics, epinephrine)
Gestational
Due to hormonal changes
DIABETES
What drug class is the drug Glipizide?
A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. NSAID
B. Sulfonylureas
What is the drug action of Glipizide?
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
What is a side effect of Glipizide?
Side Effects
Drowsiness, headache, confusion, visual disturbances, GI disturbances, anxiety
What is a adverse effect of Glipizide
Adverse Reactions
Hypoglycemia, tachycardia
Seizures, coma respiratory depression
Should you use Glipizide with Beta 2 blockers ?
A. Yes
B. No
Interactions
Alcohol – Antabuse type reaction
Beta blockers
Green tea – increases hypoglycemia
Many other
Should you use Glipize for a pt with kidney or Liver failure ?
A. Yes
B. No
B. No
Contraindications
Liver or kidney dysfunction
What drug class is Metformin?
A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. NSAID
A. Biguanides
What is the action of Metformin?
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
Side effects of Metformin
Side effects
Dizziness, fatigue, headache
Agitation
Bitter or metallic taste
Weight loss
GI symptoms – abdominal pain, bloating, discomfort
Adverse Effect of Metformin
Adverse Reactions
Hypoglycemia (not as common)
Lactic acidosis
Should you hold metformin before a pt receives contrast dye for a procedure?
A. No
B. Yes
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
What drug class is Exentinide?
A. Biguanides
B. Sulfonylureas
C. Tricyclic
D. Incretin mimetics
D. Incretin mimetics
What is the action of Exentinide?
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
Assessment for Exentidine
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
Patient Teaching for oral diabetics
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
What is the drug class for Glucagon?
Hyperglycemic Hormone
What is the action of glucagon?
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
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: C
Rationale: Metformin has a bitter or metallic taste. Seizures,
constipation, polyuria, and polydipsia are not side
effects/adverse effects of metformin.
