Week 12: Diabetes Pharmacology

Question 1

Once diagnosed with diabetes, tje standard of care is to?

Answer 1

create a person-centered goal and approach

Question 2

What are the types of medications that diabetic patients can be on? (2)

Answer 2

• insulin
• oral anti-hyperglycemics (OAH), each with different MOAs

Question 3

When is exogenous (injected) insulin given? (2)

Answer 3

• required when a patient has inadequate insulin to meet specific metabolic needs
• insulin regimes are tailored to an individual’s needs and lifestyle

Question 4

When may insulin be used? (3)

Answer 4

• May be used in isolation
• May be used in combination with oral antihyperglycemic agents (OHAs)
• various types of insulin that differ in onset, peak of action, and duration

Question 5

Which drug class does metformin belong to?

Answer 5

• biguanides

basically stops the liver from producing glucose

Question 6

Why would a patient be on metformin?

Answer 6

• first drug of choice for most patients after an initial diagnoses of diabetes

Question 7

What is the MOA of metformin? (4)

Answer 7

Lowers blood glucose and improves glucose in three ways:
1. Inhibits glucose production in the liver
2. It sensitizes insulin receptors in target tissues (fat and skeletal muscle), increasing glucose uptake
3. Slightly reduces glucose absorption in the gut

Question 8

What does metformin do to the kidneys (nursing consideration)? (3)

Answer 8

• metformin is not metabolized but secreted unchanged by the kidneys
• In the event of renal impairment, metformin can accumulate to toxic levels
• Ask yourself if the pt is at risk for dehydration

Question 9

What are the side effects of metformin? (2)

Answer 9

• GI disturbance
• appetite suppression (weight loss)

Question 10

What are the adverse effects of metformin? Who should avoid it?

Answer 10

Lactic acidosis
- avoid with pts who have kidney disease, severe infection, or history of lactic acidosis

Question 11

Does metformin cause weight gain?

Answer 11

no

Question 12

Does metformin cause hypoglycemia? Which pts is in well suited for?

Answer 12

• no
• therefore good for pts who skip meals

Question 13

What drug class is gliclazide in?

Answer 13

• sulfonylureas

Question 14

Why would a pt be on gliclazides?

Answer 14

• Treatment of diabetes

Question 15

How does gliclazide work?

Answer 15

• Stimulates the release of insulin from pancreatic beta cells, and may increase target cell sensitivity to insulin

Question 16

What are secretagogues?

Answer 16

• drugs that increase insulin secretion

Question 17

What are the adverse effects of gliclazides? (3)

Answer 17

• Can cause hypoglycemia
• Dose-dependent reduction in blood glucose
• Regardless of what the pt’s blood sugar is, this med will make it go lower

Question 18

When should pts take gliclazide?

Answer 18

• right before or with meals

Question 19

How is gliclazide eliminated?

Answer 19

• hepatic metabolism and renal excretion

Question 20

What are the side effects of gliclazide?

Answer 20

Can cause weight gain