Questions and Answers
Which of the following are main diabetes drug classifications? (Select all that apply)
What is the prototype drug for incretin enhancers?
exenatide
What is the prototype drug for alpha-glucosidase inhibitors?
acarbose
What is the prototype drug for biguanides?
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What are the prototype drugs for sulfonylureas?
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What is the prototype drug for antihypoglycemics?
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What is the prototype drug for hypoglycemics?
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What is one action of incretin enhancers like exenatide?
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Your brain needs _____?
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What are some adverse effects of incretin enhancers?
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What is a nursing intervention for patients taking incretin enhancers?
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What action do alpha-glucosidase inhibitors have on carbohydrates?
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What are some adverse effects of alpha-glucosidase inhibitors?
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What is an important nursing intervention for alpha-glucosidase inhibitors?
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Why is it important to treat hypoglycemia with dextrose instead of sucrose when taking alpha-glucosidase inhibitors?
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What is one action of biguanides like metformin?
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What are some adverse effects of biguanides?
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What nursing interventions should be monitored for biguanides?
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What is one action of sulfonylureas like glyburide?
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Study Notes
Main Diabetes Drug Classifications
- Key classifications include:
- Incretin enhancers ("tide")
- Alpha-glucosidase inhibitors
- Biguanides
- Sulfonylureas ("ide")
- Antihypoglycemic
- Hypoglycemic
Incretin Enhancers
- Prototype drug: exenatide
- Other drugs include albiglutide, dulaglutide, and liraglutide
Alpha-Glucosidase Inhibitors
- Prototype drugs: acarbose and miglitol
Biguanides
- Prototype drug: metformin
Sulfonylureas
- Second-generation prototype drugs: glyburide, glipizide, glimepiride, and glyburide micronized
- First-generation prototype drugs: chlorpropamide, tolazamide, and tolbutamide
Antihypoglycemic
- Prototype drug: glucagon and dextrose 50%
Hypoglycemic
- Prototype drug: short-acting regular insulin
Actions of Incretin Enhancers
- Stimulate insulin secretion from pancreatic beta cells
- Suppress glucagon release from the liver
- Delay gastric emptying, allowing more time for insulin to respond to glucose
Brain's Sugar Requirement
- The brain requires sugar for proper functioning
Adverse Effects of Incretin Enhancers
- Common gastrointestinal issues: nausea/vomiting (N/V), diarrhea
- Other effects: anorexia, abdominal pain, metallic taste, and injection site reactions
Nursing Interventions for Incretin Enhancers
- Educate patients on injection technique (45-90 degrees)
- Monitor for GI distress, hypoglycemia, and pancreatitis symptoms
- Assess injection site for reactions
- Regularly check lab tests: fasting blood sugar (FBS), blood sugar (BS), HbA1c, renal function, and liver function tests (LFT)
- Administer 60 minutes before meals
- Teach correct medication preparation and needle disposal
- Check BS before administration; withhold if BS is below 60
- Instruct on symptoms of hypo/hyperglycemia
Actions of Alpha-Glucosidase Inhibitors
- Delay carbohydrate digestion and absorption in the small intestine
- Allow pancreatic beta cells time to release insulin
- Not all sugars will be absorbed due to the mechanism of action
Adverse Effects of Alpha-Glucosidase Inhibitors
- Gastrointestinal symptoms: flatulence, cramping, diarrhea, abdominal distention
Nursing Interventions for Alpha-Glucosidase Inhibitors
- Treat hypoglycemia with dextrose instead of sucrose
- Monitor lab tests: BS, HbA1c, LFT, hemoglobin, and hematocrit (H&H)
- Observe for weight changes and hypoglycemia symptoms, especially when combined with other medications
- Conduct bowel assessments
- Educate on potential herbal interactions with ginseng and garlic
Importance of Dextrose for Hypoglycemia
- Dextrose provides immediate glucose to the bloodstream; sucrose requires digestion and absorption, which is delayed by alpha-glucosidase inhibitors
Actions of Biguanides (Metformin)
- Increases insulin receptor binding and tissue sensitivity
- Enhances glucose transport into muscle and fat tissues
- Suppresses gluconeogenesis and liver glucose production
Adverse Effects of Biguanides (Metformin)
- Gastrointestinal symptoms: flatulence, diarrhea, nausea, anorexia, abdominal pain, and a bitter/metallic taste
Nursing Interventions for Biguanides (Metformin)
- Monitor vital signs and BS frequently
- Watch for lactic acidosis symptoms: malaise, respiratory depression, abdominal distress
- Assess cardiopulmonary status and monitor relevant lab tests: glycosuria, ketones, FBS, HbA1c, and RBC counts
- Report any fluid or electrolyte imbalances
Actions of Sulfonylureas (Glyburide)
- Stimulate pancreatic beta cells to release insulin
- Decrease glucose output from the liver
- Increase insulin sensitivity in peripheral tissues
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Description
Explore key classifications of diabetes medications, including incretin enhancers, alpha-glucosidase inhibitors, biguanides, and sulfonylureas. This quiz covers the prototype drugs and their actions, helping you understand their roles in diabetes management.
