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anti-diabetics
oral hypoglycemics, insulin
| Question | Answer |
|---|---|
| hormone of the pancreas | insulin |
| promotes the conversion of glucose to glycogen | insulin |
| insulin is not given with | hypoglycemia |
| metformin lowers blood glucose by | increasing endogenous insulin by beta cells and increasing insulin sensitivity. Must have intact pancreas. |
| miglitol delays the digestion of ingested carbs... | and lowers blood glucose especially after meals |
| when a patient has hypoglycemia | give sugar |
| discontinue metformin if | DKA or lactic acidosis |
| monitor these for effectiveness | Blood sugar and hbA1c |
| Sulfonylureas | glimiperide, Glipizide, Glyburide |
| TZD | pioglitazone, rosaglitazone |
| biguanide | Metformin |
| Meglitides | repaglinide |
| do not use these with BB b/c they mask signs of hypoglycemia | sulfonylureas |
| taken daily with first main meal | sulfonylureas |
| action of these only are short lived and action only lasts during digestion | Meglitinides |
| Prandin and Starlix are examples of | meglitinides |
| take within 30 minutes ac meals | meglitinides |
| does not cause hypoglycemia b/c does not promote insulin release | biguanides (Metformin) |
| Glucophage | biguanide |
| take with food at breakfast and dinner, tid max | biguanide (Metformin, Glucophage) |
| can take these without regard to food | TZD (Avandia, rosiglitazone) |
| can be taken once or in divided doses | TZD |
| side effects can include fluid retention, hepatotoxicity, elevation in LDLs | TZD |
| acarbose (Precose) or miglitol (Glyset) | Alpha - Glucosidase inhibitors |
| slows carb absorption and digestion | AGI |
| side effects of AGI include | intestinal effects, risk of anemia, hepatotoxicity with long term use |
| monitor closely for hypoglycemia if mixing AGI with these | sulfonylureas, metformin, or insulin |
| use in case of insulin overdose | Glucagon |
| short rapid acting insulins | Lispro (Humalog) or Aspart (Novolog) |
| take 5- 15 minutes ac meals, 10-30 meal onset, and peaks between 0.5 to 3 hours | short rapid acting insulins (Lispro and Aspart) |
| Short-Slower Acting Insulin | Regular (Humulin R and Novolin R) |
| only insulin can give IV | regular |
| duration of regular insulin | 6-10 hours |
| give 20-30 minutes before meals | regular |
| onset is 30-60 minutes | regular Insulin (Humulin R and Novolin R) |
| peaks in 1 to 5 hours | Regular Insulin |
| Intermediate Acting Insulin | NPH (Humulin -N, Novolin - N) |
| duration is 16-24 hours and take twice daily at same times | NPH |
| one to two hours onset | NPH |
| 6-14 hours peak time | NPH (Humulin-N, Novolin-N) |
| Long Acting Insulin | Glargine, Lantus |
| no peak time, and lasts all day long!!! | Lantus |
| Only have to take once a day! | Lantus |
| Always draw this first when mixing insulin | clear shorter acting insulin |
| the color of long acting insulin | cloudy |
| clear before | cloudy |
| target preprandial BS | 90-130 mg/dL |
| target postprandial BS | <180 mg/dL |
| glycosylated hemoglobin target level | <7 |
| this oral drug is good for irregular eating patterns | meglitinides |
| this drug group keeps the liver from releasing too much glucose | biguanides |
| causes lactic acidosis in clients with renal impairment | biguanides |
| safe for pregnancy and pediatrics | biguanides (glucophage, metformin) |
| work in the small intestine to slow digestion of carbs | alpha-glucosidase inhibitors |
| hypoglycemia can occur with insufficeint food intake with this drug group | alpha glucosidase inhibitors (acrabose, miglitol) |
| must be treated with oral glucose and not complex carbs | acrabose and miglitol |
| check LFTs every two months for a year and interacts with cholesterol lowering drugs by decreasing its own effects | TZDs |
| inhaled rapid acting insulin | Exubera (absorption effected by URI, COPD, smoking) |
| Glucagon-like peptide | given sub-q in multidose pen |
| synthetic amylin (hormone released by beta cells) | Symlyn |
| promotes insulin synthesis and release, and inhibits glucagon secretion | Januvia |
| local allergic reaction to insulin therapy | rash, urticaria, other skin reactions |
| systemic allergic reaction to insulin therapy | anaphylaxis; serum sickness - fever, myalgias, enlarged spleen and lymph nodes, |
Created by:
hong204
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