36 Questions
Which class of oral antidiabetic medications reduces insulin resistance in target tissues?
Biguanides
What is the mechanism of action of thiazolidinediones?
Reducing insulin resistance in target tissues
In what circumstances may the use of oral antidiabetic medications need to be halted temporarily?
In response to hyperglycemia from infection, trauma, or surgery
Which oral antidiabetic agents are insulin secretagogues?
Second-generation sulfonylureas
When are oral antidiabetic agents prescribed as an addition to other treatment modalities?
As an addition to MNT and exercise
How may the effects of oral antidiabetic medications be enhanced?
By combining with insulin therapy
Which medication delays digestion of complex carbohydrates into glucose?
Acarbose
What is the primary effect of Metformin?
Reduces glucose production by the liver and increases insulin sensitivity
What is a potential side effect of Acarbose?
Gastric upset
In which patient population may Metformin be considered ideal?
Overweight people with type 2 diabetes
How should Acarbose be taken to delay digestion of carbohydrates?
At the beginning of each meal
What should be done if gastric distress occurs while taking Glyburide?
Take it before breakfast or in divided doses before meals
What is the primary adverse effect of metformin?
Lactic acidosis
When is it advised to cease the use of metformin?
If renal impairment occurs or if serum lactate increases
What is the black box warning for metformin related to?
Risk of lactic acidosis in patients 80 years or older
What is the role of rosiglitazone in glucose regulation?
Stimulates insulin receptors on muscle, fat, and liver cells
What should nurses monitor when administering metformin?
Renal function and therapeutic/adverse effects
What is a contraindication for metformin use?
Diabetes complicated by fever
What is the main adverse effect of glyburide?
Hypoglycemia
In which patients is caution required when using glyburide?
Patients with renal impairment
What is the recommended initial approach when using glyburide in combination with diet to lower blood sugar in patients with type 2 diabetes mellitus?
Begin with a low dosage and gradually increase it until fasting blood glucose level is 110 mg/dL or less
What is the approved use of pramlintide for diabetes management?
To control hyperglycemia in adults not achieving acceptable glucose control with insulin at mealtimes
What is the relationship between pramlintide and insulin therapy?
Pramlintide is used with insulin, not as a substitute
What is the role of IV glucose in the event of severe hypoglycemia?
It is necessary to administer IV glucose in the event of severe hypoglycemia
What is a severe adverse effect of rosiglitazone?
Congestive heart failure
What is a contraindication to rosiglitazone use?
Active liver disease
What is the mechanism of action of repaglinide?
Stimulates pancreatic secretion of insulin
What should be monitored in patients taking rosiglitazone?
Therapeutic effects and adverse effects
What is the most common adverse effect of repaglinide?
Hypoglycemia
In which patients is repaglinide contraindicated?
Type 1 diabetes
What is a severe adverse effect of rosiglitazone?
Congestive heart failure
What is a contraindication to rosiglitazone use?
Active liver disease
What is the main adverse effect of repaglinide?
Hypoglycemia
How does repaglinide work?
Stimulates pancreatic secretion of insulin
What has the FDA issued a BLACK BOX WARNING about regarding rosiglitazone?
The risk of congestive heart failure
What should patients using rosiglitazone be assessed for?
Therapeutic effects and adverse effects
Study Notes
Rosiglitazone and Repaglinide: Adverse Effects, Nursing Implications, and Patient Use
- Rosiglitazone has severe adverse effects including congestive heart failure and myocardial infarction
- Contraindications to rosiglitazone use include active liver disease, serum alanine aminotransferase value more than 2.5 times the upper limit of normal, and hypersensitivity to the drug
- Rosiglitazone increases plasma volume and may cause fluid retention leading to heart failure in some users
- FDA has issued a BLACK BOX WARNING about the risk of congestive heart failure in patients using pioglitazone and rosiglitazone
- Rosiglitazone should be taken with meals and patients should be assessed for therapeutic effects and adverse effects
- Patients should report any signs or symptoms of congestive heart failure to healthcare personnel
- Repaglinide is a meglitinide that stimulates pancreatic secretion of insulin and can be used in combination with metformin or insulin for greater reduction in hemoglobin A1C
- Repaglinide is well absorbed from the GI tract, has a short half-life, and is metabolized in the liver
- Repaglinide works by closing potassium channels in pancreatic beta cells, causing insulin release
- Dosage of repaglinide should be adjusted in patients with renal or hepatic impairment
- Hypoglycemia is the most common adverse effect of repaglinide
- Repaglinide is contraindicated in patients with hypersensitivity, Type 1 diabetes, or diabetic ketoacidosis
Test your knowledge of pharmacologic management of diabetes with a focus on oral agents and insulin therapy. This quiz covers topics such as the combination of oral agents with insulin, adverse effects of medications like rosiglitazone and repaglinide, and nursing implications for patient use. Perfect for healthcare professionals and students seeking to enhance their understanding of diabetes management.
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