Diabetes Drugs

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Author:
jborlongan8626
ID:
155656
Filename:
Diabetes Drugs
Updated:
2012-05-24 12:11:36
Tags:
NCLEX
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Description:
Medical-Surgical
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  1. What are the common rapid-acting insulin?
    • lispro (Humalog)
    • aspart (NovoLog)
    • glulisine (Apidra)
  2. What are the common short-acting insulin?
    regular (Novolin R)
  3. What are the common intermediate-acting insulin?
    • NPH (Humulin N)
    • detemir (Levemir)
  4. What are the common long-acting insulin?
    glargine (Lantus)
  5. What is the Onset, Peak, & Duration of rapid-acting insulin?
    • Onset: 15-20 min
    • Peak: 1-2 hr
    • Duration: 3-4 hr
  6. What is the Onset, Peak, & Duration of short-acting insulin?
    • Onset: 30 min
    • Peak 2-4 hr
    • Duration 5-8 hr
  7. What is the Onset, Peak, & Duration of intermediate-acting insulin?
    • Onset: 1-1.5 hr
    • Peak: 4-12 hr
    • Duration 16-24 hr
  8. What is the Onset, Peak, & Duration of long-acting insulin?
    • Onset: 2-4 hr
    • Peak: none
    • Duration 24 hr
  9. Which insulin are cloudy and clear?
    Short-acting & Long-acting are clear insulin.

    Intermediate-acting is cloudy insulin.
  10. Intervention for rapid-acting insulin?
    • Give within 15 min of meal
    • May be mixed with longer acting insulin
  11. Intervention for short-acting insulin?
    • Only insulin given IV
    • May be mixed with intermediate-acting insulin
    • Used to treat DKA & newly dx T1DM
  12. Intervention for intermediate-acting insulin?
    Given often in combination with regular insulin
  13. Interventino for long-acting insulin?
    • Used as basal coverage once or twice daily
    • Usually given at bedtime
    • DO NOT MIX WITH ANY OTHER INSULIN
  14. S/S of hypoglycemia
    • confusion
    • cool pale skin
    • nausea
    • diaphoresis
    • increase HR
  15. AE of insulin
    • hypoglycemia
    • lipodystrophy (fat wasting or accumulation)
    • itching
    • redness at site
  16. What drugs are in the class of Biguanide?
    • metformin (Glucophage)
    • metformin oral solution (Riomet)
    • metformin extended release (Glucophage XR)
  17. Action of Biguanide class of drugs
    • Reduces liver glucose production.
    • Increases sensitivity to insulin.
    • Improves glucose transport into cells.
  18. Assessments when taking Biguanide class of drugs
    • Monitor BS.
    • Observe for S/S of hypoglycemia.
    • Assess renal/liver function at start & annually.
    • Long term use - monitor folic acid & Vit B12.
  19. Interventions for the drug metformin
    HOLD DOSE FOR ANY SURGERY/PROCEDURE WITH RESTRICTED INTAKE AND WHEN IV CONSTRAST MEDIA USED AND 48 HRS AFTERWARDS

    Give with meal to minimize GI effect
  20. AE of Biguanide class
    • abdominal bloating
    • diarrhea
    • N/V
    • R/F lactic acidosis (especially if kidney problems)
  21. What drugs are in the class of Sulfonylureas?
    • glipizide (Glucotrol)
    • glyburide (Diabeta)
    • glimepiride (Amaryl)
  22. Action of Sulfonylureas class of drugs
    • Lowers BG by stimulating release of insulin from pancreas.
    • Increasing insulin sensitivity.
  23. Assessments when taking Sulfonylureas class of drugs
    • Monitor BS
    • Observe for S/S of hypoglycemia
    • Assess for allergies to sulfonamides
    • Monitor BUN & creatinine
  24. Interventions for the drug class of Sulfonylureas
    • Administer with 1st meal of day.
    • Many drug to drug interactions.
  25. AE of Sulfonylureas class
    • Hypoglycemia
    • Wt. gain
    • Photosensitivity
    • Dizziness
    • Kidney or liver dysfunction more susceptible to hypoglycemia
  26. What drugs are in the class of Meglitinides?
    • repaglinide (Prandin)
    • nateglinide (Starlix)
  27. Action of Meglitinide class of drugs
    • Action similar to sulfonylureas but works at different receptor site.
    • Faster onset and shorter duration.
  28. Assessments of Meglitinide class of drugs
    • Monitor BS
    • Observe for S/S of hypoglycemia
  29. Interventions for Meglitinides class of drugs
    • Give up to 30 min before meals
    • Rapid onset
    • SKIP DOSE IF SKIPPING MEAL
  30. AE of Meglitinides class of drugs
    • Hypoglycemia
    • URI
    • Cough
    • Arthralgia
    • Do not take with Lopid
  31. What drugs are in the class of Alpha-Glucosidase Inhibitors (starch blockers)?
    • acarbose (Precose)
    • miglitol (Glyset)
  32. Action of startch blockers
    • Works in intestines to slow digestion of carbs.
    • Delays and reduces glucose absorption.
  33. Assessments of starch blockers class of drugs
    • Monitor BS
    • Observe for S/S of hypoglycemia after meals
  34. Interventions of starch blockers class of drugs
    • GIVE WITH FIRST BITE OF EACH MEAL
    • If hypoglycemia, treat with glucose (tabs or gel) or milk
  35. AE of starch blockers class of drugs
    • Abdominal pain
    • Diarrhea
    • Flatulence
    • Risk of hypoglycemia if taken with other diabetic medications
  36. What drugs are in the class of Thiazolidinediones (TZD)?
    • rosiglitazone (Avandia)
    • pioglitazone (Actos)
  37. Action of TZD
    • Improves insulin sensitivity in muscle cells
    • Decreases insulin resistance
    • Enhances insulin action
  38. Assessments of TZD class of drugs
    • Monitor BS
    • Observe for S/S of hypoglycemia if taking insulin
    • Assess for edema
    • S/S of HF and elevated liver enzymes
  39. Interventions of TZD class of drugs
    • Administer with or without food
    • BLACK BOX WARNING FOR AVANDIA: INCREASE RISK FOR MI, CVA, DO NOT USE WITH HF
  40. AE of TZD class of drugs
    • May cause increase total cholesterol and LDL
    • HF, edema, wt. gain
    • Metabolized entirely by liver, so should not be used with liver dysfunction
  41. What drugs are in the class of Incretin mimetic
    • exenatide (Byetta)
    • liraglutide (Victoza)
  42. Action of Incretin mimetic class of drugs
    • Mimics action of incretins (gut hormones) by stimulating insulin secretion and inhibiting glucagon after ingestion of carbohydrates
    • Promotes feeling of satiety
  43. Assessments of Incretin mimetic class of drugs
    • Monitor BS
    • Observe for S/S of hypoglycemia especially when taking TZDs
  44. Intervention of Incretin mimetic class of drugs
    • Only used in T2 DM
    • SQ injection from pre-filled pen into thigh or abdomen before breakfast/dinner
    • Used with biguanide and/or sulfonylurea
    • Profoundly slows gastric emptying & can affect absorption of oral meds
  45. SE of Incretin mimetic class of drugs
    • Diarrhea
    • N/V (usally with first doses)
    • Dizziness
    • H/A
    • Minimal R/F hypoglycemia
    • Acute pancreatitis & kidney problems have been associated with Byetta use
  46. What drugs are in the class of Dipeptidyl Peptidase IV Inhibitor (DPP-4)
    • sitagliptin (Januvia)
    • saxagliptin (Onglyza)
  47. Action of DPP-4
    DPP-4 (an enzyme that breaks down incretin hormones), is inhibited increasing & prolonging action of incretin hormones by slowing inactivation
  48. Assessments of DPP-4 class of drugs
    • Monitor S/S of hypoglycemia especially if taken with sulfonylureas
    • Assess renal function tests before starting & regularly during therapy
  49. Interventions of DPP-4 class of drugs
    • 24 hr duration of action
    • Decrease dose if renal dysfunction
  50. SE of DPP-4 class of drugs
    • Stuffy or runny nose
    • Sore throat
    • URI
    • H/A
    • Nausea
    • Diarrhea
    • does not cause wt. gain
    • Pancreatitis
  51. What drugs are in the class of Amylin Mimetic?
    pramlinitide (Symlin)
  52. Action of Amylin Mimetic class of drugs
    • Mimics action of amylin (pancreatic hormone) that controls after meal glucose by slowing gastric emptying
    • Suppressing glucagon secretion
    • Triggering satiety (decrease caloric intake & wt. loss)
  53. Assessments of Amylin Mimetic class of drugs
    • Monitor BS
    • Assess for S/S of hypoglycemia within 3 hrs of injection when used with insulin
  54. Intervention of Amylin Mimetic class of drugs
    • Dose depends on T1 or T2 DM
    • Used in conjunction with insulin therapy
    • Administered as SQ STAT before meals (2 separate syringes must be used)
    • DO NOT MIX WITH INSULIN
    • Rapid onset
  55. AE of Amylin Mimetic class of drugs
    • Severe hypoglycemia when used with insulin
    • May need to reduce insuln dose
    • Nausea, vomitting, anorexia

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