Diabetes Drug Classifications Overview

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Questions and Answers

Which of the following are main diabetes drug classifications? (Select all that apply)

  • Incretin enhancers 'tide' (correct)
  • Biguanides (correct)
  • Alpha-glucosidase inhibitors (correct)
  • Antihypoglycemic (correct)
  • Hypoglycemic (correct)
  • Sulfonylureas 'ide' (correct)

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?

<p>metformin</p> Signup and view all the answers

What are the prototype drugs for sulfonylureas?

<p>glyburide</p> Signup and view all the answers

What is the prototype drug for antihypoglycemics?

<p>glucagon</p> Signup and view all the answers

What is the prototype drug for hypoglycemics?

<p>regular insulin</p> Signup and view all the answers

What is one action of incretin enhancers like exenatide?

<p>promote insulin secretion from the pancreas</p> Signup and view all the answers

Your brain needs _____?

<p>sugar</p> Signup and view all the answers

What are some adverse effects of incretin enhancers?

<p>Nausea (A), Diarrhea (B), Metallic taste (D)</p> Signup and view all the answers

What is a nursing intervention for patients taking incretin enhancers?

<p>Monitor signs/symptoms of GI distress</p> Signup and view all the answers

What action do alpha-glucosidase inhibitors have on carbohydrates?

<p>Delay digestion and absorption</p> Signup and view all the answers

What are some adverse effects of alpha-glucosidase inhibitors?

<p>Cramping (A), Diarrhea (B), Flatulence (C)</p> Signup and view all the answers

What is an important nursing intervention for alpha-glucosidase inhibitors?

<p>Treat hypoglycemia with dextrose, NOT sucrose</p> Signup and view all the answers

Why is it important to treat hypoglycemia with dextrose instead of sucrose when taking alpha-glucosidase inhibitors?

<p>Sucrose needs to be digested and absorbed, while dextrose goes straight into the bloodstream</p> Signup and view all the answers

What is one action of biguanides like metformin?

<p>Increase tissue sensitivity to insulin</p> Signup and view all the answers

What are some adverse effects of biguanides?

<p>Metallic taste (A), Nausea (B), Flatulence (C)</p> Signup and view all the answers

What nursing interventions should be monitored for biguanides?

<p>Monitor vital signs and blood sugar frequently</p> Signup and view all the answers

What is one action of sulfonylureas like glyburide?

<p>Causes pancreatic beta cells to release insulin</p> Signup and view all the answers

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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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