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Classification for Metformin
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First line drug
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Unit 4 - Meds
Unit 4 - Medications
| Question | Answer |
|---|---|
| Classification for Metformin | Biguanide |
| First line drug | Metformin |
| Metformin indications | Hyperglycemia Decrease intestinal absorption of glucose Does NOT cause hypoglycemia |
| Metformin administration | PO |
| Metformin adverse effects | GI problems: Bloating Anorexia Abdominal discomfort |
| Metformin nursing considerations | Contraindicated in renal pts Lifestyle modifications Monitor BUN and creatinine Stop 48hrs before and after use of contrast agent |
| Classification of Glipizide, Glimepiride, Glyburide | Sulfonylureas - second line drug - added to Metformin if it doesn’t work alone |
| Indications - Glipizide, Glimepiride, Glyburide | Hyperglycemia Can be added to Metformin if HgbA1C is >7 Can cause hypoglycemia because it stimulates insulin release from beta cells type 2 |
| Glipizide, Glimepiride, Glyburide Administration | PO |
| Glipizide, Glimepiride, Glyburide - Adverse effects | Hypoglycemia Nausea Weight gain GI distress |
| Glipizide, Glimepiride, Glyburide - considerations | No alcohol - can cause hypoglycemia reaction |
| Classification of Exenatide Dulaglutide Liraglutide Alogliptin Linagliptin Saxagliptin | Incretin Enhancers- TIDE or GLIPTIN |
| Indications for incretin enhancers | Hyperglycemia Prevent breakdown of natural incretins and increases insulin secretion which lowers blood glucose |
| Action of incretin enhancers | Incretins are hormones secreted by the mucosa of the small intestine following a meal, when blood glucose is elevated. |
| Action of incretin enhances | Signal the pancreas to increase insulin production and signal the liver to decrease glucagon. Both of these actions lower blood glucose. Decrease food intake by increasing the feeling of satiety and slow gastric emptying which delays glucose absorption. |
| Administration of Exenatide Dulaglutide Liraglutide | SubQ |
| Administration of Alogliptin Linagliptin Saxagliptin | PO |
| Adverse Effects: Exenatide Dulaglutide Liraglutide | • Does not usually cause hypoglycemia • High incidence of nausea, vomiting, and diarrhea • Pancreatitis |
| Adverse Effects: Alogliptin Linagliptin Saxagliptin | • Fewer adverse effects (N, V, D) • Do not usually cause hypoglycemia • Pancreatitis |
| Nursing Considerations: Exenatide Dulaglutide Liraglutide Alogliptin Linagliptin Saxagliptin | Assess for s/s pancreatitis (persistent severe abdominal pain, sometimes radiating to the back, may be accompanied by vomiting) beginning of therapy and with dose increases. If suspected, promptly discontinue incretin enhancer and seek medical attention. |
| Nursing Considerations: Exenatide Dulaglutide Liraglutide Alogliptin Linagliptin Saxagliptin | Monitor HgbA1c prior to and during therapy. The TIDES are approved by the FDA as alternatives to metformin in patient who have not achieved glycemic control with metformin. GLIPTINs have fewer adverse effects and work well with other antidiabetic agents |
| Name Rapid Acting Insulin | Lispro (Humalog) Aspart (Novolog) |
| Rapid Acting Insulin - Indications Lispro and Aspart | • Hyperglycemia • Lowers blood sugar as it rises after meals |
| Rapid Acting Insulin - Administration, Onset, Peak and Duration | SQ Onset 15 minutes or less Peak 40-60 minutes Duration 3-5 h |
| Rapid Acting Insulin - Adverse Effects Lispro and Aspart | • Hypoglycemia |
| Rapid Acting Insulin - Nursing Considerations Lispro and Aspart | • Clear solution • “mealtime insulin” • Client should eat within 15 minutes of injection |
| Name Short Acting Insulin | Regular (Humulin-R, Novolin-R) |
| Short Acting Insulin - Indications Regular (Humulin-R, Novolin-R) | Hyperglycemia |
| Short Acting Insulin - Administration, Onset, Peak and Duration Regular (Humulin-R, Novolin-R) | SQ or IV Onset 30-60 minutes Peak 2-3 hr Duration 4-6 hr |
| Short Acting Insulin - Adverse Effects Regular (Humulin-R, Novolin-R) | Hypoglycemia |
| Short Acting Insulin - Nursing Considerations Regular (Humulin-R, Novolin-R) | • Clear solution • Administer 20-30 minutes before meals • Can be given alone or mixed with other insulin |
| Name Intermediate Acting Insulin | Isophane (NPH, Humulin-N, Novolin-N) |
| Intermediate Acting Insulin - Indications Isophane (NPH, Humulin-N, Novolin-N) | • Hyperglycemia |
| Intermediate Acting Insulin - Administration, Onset, Peak and Duration Isophane (NPH, Humulin-N, Novolin-N) | SQ Onset 2-4 hr Peak 6-8 Duration 12-16hr |
| Intermediate Acting Insulin - Nursing Considerations Isophane (NPH, Humulin-N, Novolin-N) | • White and cloudy solution-has protein in it. • Usually taken after meals |
| Name Very Long Acting Insulin | Glargine |
| Very Long Acting Insulin - Indications Glargine | • Hyperglycemia • Keeps blood sugar stable between meals and overnight |
| Very Long Acting Insulin - Administration, Onset, Peak and Duration Glargine | SQ Onset 2 hr Peak – none Duration 24 h |
| Very Long Acting Insulin - Adverse Effects Glargine | Hypoglycemia |
| Very Long Acting Insulin - Nursing Considerations Glargine | • Used for basal dose • Maintains blood glucose levels regardless of meals • Cannot be mixed with other insulins • Given at bedtime |
| Classification of Travoprost Latanoprost | Prostaglandins “prost”- first line therapy |
| Indications for Travoprost Latanoprost | • Increases ocular outflow through trabecular meshwork to decrease IOP, used to treat open angle glaucoma |
| Administration of Travoprost Latanoprost | Optic - Eye |
| Adverse Effects of Travoprost Latanoprost | • Local irritation and redness • Brown pigmentation of the iris • Lashes may grow longer |
| Nursing Considerations for Travoprost Latanoprost | • Administered once daily at bedtime • Apply light pressure on lacrimal sac for 1 min following instillation |
| Classification of Timolol maleate Levobunolol | Beta blockers “lol” or “olol” |
| Indications of Timolol maleate Levobunolol | • Decrease production of aqueous humor and Reduces intraocular pressure in management of glaucoma • Beta blocker |
| Administration of Timolol maleate Levobunolol | Optic – Eye |
| Adverse Effects of Timolol maleate Levobunolol | • Eye irritation • Hypotension • Increased airway resistance |
| Nursing Considerations of Timolol maleate Levobunolol | • Monitor BP and pulse • Apply light pressure on lacrimal sac for 1 min following instillation • Used in caution with clients already taking beta-blockers for HTN. • Contraindicated in clients with history of asthma |
| Classification of Meclizine Diphenhydramine Fexofenadine Loratidine Chlorpheniramine | Anti-vertigo - Antihistamines |
| Indication of Meclizine | • Vertigo |
| Indications of Diphenhydramine Fexofenadine Loratidine Chlorpheniramine | • Treat allergic rhinitis, allergies, vertigo, cough, sneezing |
| Administration of Meclizine Diphenhydramine Fexofenadine Loratidine Chlorpheniramine | PO |
| Adverse Effects of Meclizine | • Headache • Vomiting • Dry mouth • Tiredness/drowsiness |
| Adverse Effects of Diphenhydramine Fexofenadine Loratidine Chlorpheniramine | • Drowsiness, excitement, photosensitivity • Anticholinergic effects-dry mouth, urinary retention, constipation |
| Nursing Considerations of Meclizine | • Avoid activities that require alertness |
| Nursing Considerations of Diphenhydramine Fexofenadine Loratidine Chlorpheniramine | • Use cautiously in CVD, HTN, renal ds. May be given pre-blood to decrease allergic response, increase fluid intake |
| Classification of Promethazine Prochlorperazine | Antiemetic |
| Indications for Promethazine Prochlorperazine | • Vertigo • Nausea • Vomiting • Sedation |
| Administration of Promethazine Prochlorperazine | PO, IV, PR |
| Adverse Effects of Promethazine Prochlorperazine | • Drowsiness • Dizziness • Constipation • Urinary retention • Dry mouth |
| Nursing Considerations of Promethazine Prochlorperazine | • If used for motion sickness, take ½ hr before traveling • Avoid activities that require alertness • Avoid alcohol/CNS depressants |
Created by:
PinkRN
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