SGLT-2 Inhibitors: Precautions & Interactions
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What is the primary reason SGLT-2 inhibitors are contraindicated for individuals with a GFR below 45 mL/min/1.73 m2?

  • Increased likelihood of hypoglycemia
  • Increased risk of dehydration
  • Reduced effectiveness due to impaired kidney function (correct)
  • Potential for severe drug interactions

    • Which of the following individuals should use SGLT-2 inhibitors with caution due to potentially reduced drug efficacy?

  • Those with a GFR over 60 mL/min/1.73 m2
  • Individuals without any comorbid conditions
  • Patients who are on a weight-loss regimen
  • Clients with severe renal impairment (correct)

    • When administering SGLT-2 inhibitors, which drug class should be monitored for increased risk of dehydration?

  • ACE inhibitors
  • Beta-blockers
  • Thiazide and loop diuretics (correct)
  • Calcium channel blockers

    • What is an important educational point for clients taking SGLT-2 inhibitors?

    <p>Maintain adequate hydration and recognize hypotension signs</p> Signup and view all the answers

    During the treatment with SGLT-2 inhibitors, which lab test should be regularly monitored to assess treatment effectiveness?

    <p>Hemoglobin A1c</p> Signup and view all the answers

    Why is it necessary to potentially adjust doses of SGLT-2 inhibitors when given with UDP-glucuronosyltransferase inducers?

    <p>Increased metabolism of the SGLT-2 inhibitor may require higher doses</p> Signup and view all the answers

    What is a primary consideration when deciding the dosing of SGLT-2 inhibitors for clients?

    <p>Glycemic control needs and renal function</p> Signup and view all the answers

    How often should oral doses of SGLT-2 inhibitors be administered?

    <p>Once before the first meal each day</p> Signup and view all the answers

    What is the primary function of SGLT-2 inhibitors in adults with type 2 diabetes?

    <p>To promote glucose excretion in the urine</p> Signup and view all the answers

    Which of the following is a unique feature of SGLT-2 inhibitors?

    <p>They promote weight loss through caloric loss</p> Signup and view all the answers

    How do SGLT-2 inhibitors facilitate improved glycemic control?

    <p>By blocking glucose reabsorption in the kidneys</p> Signup and view all the answers

    Which of the following conditions can SGLT-2 inhibitors help manage in clients who are overweight?

    <p>Hypoglycemia risk</p> Signup and view all the answers

    What is a common side effect of SGLT-2 inhibitors due to increased glucose in the urine?

    <p>Urinary Tract Infections</p> Signup and view all the answers

    Which group is particularly affected by genital fungal infections when using SGLT-2 inhibitors?

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

    What adverse reaction may occur with SGLT-2 inhibitors, especially in older adults?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    What mechanism do SGLT-2 inhibitors target to increase urinary glucose excretion?

    <p>SGLT-2 transporter</p> Signup and view all the answers

    Which of the following factors should be considered when deciding if a client is a candidate for SGLT-2 inhibitors?

    <p>Estimated glomerular filtration rate (GFR)</p> Signup and view all the answers

    Which of the following statements about the dosing of SGLT-2 inhibitors is accurate?

    <p>Oral dosing is recommended once daily before the first meal.</p> Signup and view all the answers

    What lab tests should be routinely monitored in clients taking SGLT-2 inhibitors?

    <p>Kidney function and blood glucose levels</p> Signup and view all the answers

    When co-administering SGLT-2 inhibitors with diuretics, clients should be cautious of which potential risk?

    <p>Dehydration and hypotension</p> Signup and view all the answers

    Which client condition would justify the addition of SGLT-2 inhibitors to their treatment regimen?

    <p>History of heart failure</p> Signup and view all the answers

    What is a significant precaution for clients with renal impairment when using SGLT-2 inhibitors?

    <p>They may experience more pronounced side effects.</p> Signup and view all the answers

    Clients taking SGLT-2 inhibitors are advised to recognize which symptoms to manage potential hypoglycemia?

    <p>Dizziness and sweating</p> Signup and view all the answers

    Which factor is not a reason why dosing of SGLT-2 inhibitors may need adjustment?

    <p>Variations in the client's diet</p> Signup and view all the answers

    What is the primary category of SGLT-2 inhibitors?

    <p>Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors</p> Signup and view all the answers

    Which of the following is a potential benefit of SGLT-2 inhibitors aside from lowering blood glucose levels?

    <p>Weight loss due to caloric loss</p> Signup and view all the answers

    Which condition may be exacerbated due to increased glucose in the urine when using SGLT-2 inhibitors?

    <p>Urinary Tract Infections</p> Signup and view all the answers

    What mechanism do SGLT-2 inhibitors primarily utilize to achieve their effect?

    <p>Blocking the reabsorption of glucose in the kidneys</p> Signup and view all the answers

    Which of the following is a common side effect associated with SGLT-2 inhibitors?

    <p>Urinary Tract Infections</p> Signup and view all the answers

    What risk is particularly heightened in older adults using SGLT-2 inhibitors?

    <p>Orthostatic Hypotension</p> Signup and view all the answers

    Which type of patients may benefit from SGLT-2 inhibitors alongside standard diabetes treatment?

    <p>Overweight patients or those at risk of hypoglycemia</p> Signup and view all the answers

    What percentage of glucose reabsorption in the kidneys does the SGLT-2 transporter account for?

    <p>90%</p> Signup and view all the answers

    Which of the following clients should avoid the use of SGLT-2 inhibitors?

    <p>A client with a GFR below 45 mL/min/1.73 m2</p> Signup and view all the answers

    What specific effect may result from combining SGLT-2 inhibitors with thiazide diuretics?

    <p>Higher risk of dehydration</p> Signup and view all the answers

    In which scenario might SGLT-2 inhibitors require dosage adjustment?

    <p>In conjunction with certain enzyme-inducing medications</p> Signup and view all the answers

    During treatment with SGLT-2 inhibitors, which laboratory parameter is essential for assessing kidney function?

    <p>Basic metabolic panel</p> Signup and view all the answers

    What should clients taking SGLT-2 inhibitors be educated on regarding hydration?

    <p>They need to monitor for signs of infection and hypotension</p> Signup and view all the answers

    Which factor could indicate the addition of SGLT-2 inhibitors to a treatment regimen?

    <p>The client has ASCVD or heart failure</p> Signup and view all the answers

    What is the recommended frequency for administering oral doses of SGLT-2 inhibitors?

    <p>Once daily before breakfast</p> Signup and view all the answers

    What monitoring is essential for assessing the effectiveness of treatment with SGLT-2 inhibitors?

    <p>Hemoglobin A1c levels</p> Signup and view all the answers

    What is the mechanism through which SGLT-2 inhibitors improve glycemic control?

    <p>They block the reabsorption of glucose in the kidneys.</p> Signup and view all the answers

    Which of the following side effects is most likely associated with SGLT-2 inhibitors due to increased glucose in the urine?

    <p>Urinary tract infections.</p> Signup and view all the answers

    In which group of patients are SGLT-2 inhibitors most likely to be beneficial?

    <p>Patients with hypoglycemia risk.</p> Signup and view all the answers

    What unique feature of SGLT-2 inhibitors may contribute to weight loss in clients?

    <p>Glycosuria leading to caloric loss.</p> Signup and view all the answers

    What potential risk is important to monitor in older adults using SGLT-2 inhibitors?

    <p>Orthostatic hypotension.</p> Signup and view all the answers

    Which function do SGLT-2 inhibitors primarily serve in treating type 2 diabetes?

    <p>Increasing urinary glucose excretion.</p> Signup and view all the answers

    What is a primary indication for prescribing SGLT-2 inhibitors?

    <p>To improve glycemic control in adults with type 2 diabetes.</p> Signup and view all the answers

    Which factor is a contraindication for the use of SGLT-2 inhibitors?

    <p>Impaired renal function.</p> Signup and view all the answers

    Which of the following drugs is classified as an SGLT-2 inhibitor?

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

    What is one of the unique features of SGLT-2 inhibitors that can aid in weight management?

    <p>Glycosuria leading to weight loss</p> Signup and view all the answers

    SGLT-2 inhibitors primarily promote glucose excretion through which main mechanism?

    <p>Inhibiting glucose reabsorption in the kidneys</p> Signup and view all the answers

    In addition to lowering blood glucose, SGLT-2 inhibitors can be beneficial for which of the following patient characteristics?

    <p>Patients who are overweight</p> Signup and view all the answers

    Which of the following best describes the primary function of SGLT-2 inhibitors?

    <p>Lower blood glucose levels by promoting urinary glucose excretion</p> Signup and view all the answers

    What additional condition can SGLT-2 inhibitors specifically help manage in clients who are overweight?

    <p>Hypoglycemia risk</p> Signup and view all the answers

    Which statement accurately reflects a unique feature of SGLT-2 inhibitors?

    <p>They promote weight loss through glycosuria.</p> Signup and view all the answers

    Which of the following drugs is an example of an SGLT-2 inhibitor?

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

    What is the primary mechanism by which SGLT-2 inhibitors lower blood glucose levels?

    <p>Promoting glucose excretion in urine</p> Signup and view all the answers

    What percentage of glucose reabsorption in the kidneys is primarily accounted for by the SGLT-2 transporter?

    <p>90%</p> Signup and view all the answers

    What is a significant benefit of SGLT-2 inhibitors besides lowering blood glucose levels?

    <p>They promote weight loss through glycosuria.</p> Signup and view all the answers

    In which scenario would the use of SGLT-2 inhibitors be particularly beneficial?

    <p>Clients who are overweight or at risk of hypoglycemia.</p> Signup and view all the answers

    Which of the following drugs is an example of an SGLT-2 inhibitor?

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

    What mechanism do SGLT-2 inhibitors target in the body?

    <p>Promoting urinary glucose excretion</p> Signup and view all the answers

    Which condition should SGLT-2 inhibitors be used with caution due to a possible adverse effect?

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

    What is the primary benefit of using SGLT-2 inhibitors in adults with type 2 diabetes?

    <p>Lowering blood glucose levels through urine glucose excretion</p> Signup and view all the answers

    Which of the following conditions may benefit from the use of SGLT-2 inhibitors in the treatment plan?

    <p>Obesity with type 2 diabetes</p> Signup and view all the answers

    What unique feature is associated with the use of SGLT-2 inhibitors that can contribute to weight loss?

    <p>Glycosuria leading to calorie loss</p> Signup and view all the answers

    Which SGLT-2 inhibitor is also known as Invokana?

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

    Which statement accurately reflects a potential effect experienced by clients taking SGLT-2 inhibitors?

    <p>Genital fungal infections due to glycosuria</p> Signup and view all the answers

    Study Notes

    SGLT-2 Inhibitors: Precautions & Contraindications

    • Renal impairment: Caution is advised for clients with severe renal impairment or those undergoing dialysis. SGLT-2 inhibitors are less effective in individuals with impaired kidney function.
    • GFR below 45 mL/min/1.73 m2: Contraindicated in individuals with an estimated glomerular filtration rate (GFR) below this threshold.

    Drug Interactions

    • UDP-glucuronosyltransferase inducers: Co-administration with inducers like rifampin, phenytoin, or phenobarbital may require increased doses of the SGLT-2 inhibitor.
    • Thiazide and loop diuretics: Co-administration can increase the risk of dehydration and hypotension due to the diuretic effect of SGLT-2 inhibitors.

    Dosing & Administration

    • Dosing: Varies based on condition, severity, and client response. Check drug dosing guidelines for individualized dosing. Administered orally once per day before the first meal.
    • Administration: Administered orally (PO). Not recommended for clients with severely impaired kidney function.

    Client Teaching

    • Blood Glucose Monitoring: Clients should regularly monitor their blood glucose levels to avoid hypoglycemia.
    • Hypoglycemia Recognition and Management: Educate clients on recognizing the signs and symptoms of hypoglycemia and how to manage it should it occur.
    • Hydration and Monitoring: Educate clients about hydration and monitoring for signs of infections or hypotension.

    Labs to Monitor

    • Basic Metabolic Panel (BMP): Regular monitoring of kidney function and blood glucose levels is recommended to adjust dosing accordingly.
    • Hemoglobin A1c: Monitoring hemoglobin A1c provides information on the effectiveness of the treatment regimen.

    Canagliflozin (Invokana)

    • Category: Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors (Oral Hypoglycemic Agent)
    • Primary Function: Lowers blood glucose levels in adults with type 2 diabetes by promoting glucose excretion in the urine. Can be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia.
    • Unique Features: Glycosuria from SGLT-2 inhibitors can also cause weight loss.

    Mechanism of Action

    • Glucose Reabsorption Inhibition: SGLT-2 inhibitors block the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion.
    • Glycemic Control and Weight Loss: By targeting the SGLT-2 transporter, which is responsible for approximately 90% of glucose reabsorption, these inhibitors improve glycemic control and offer the added benefit of weight loss due to caloric loss.

    Indications & Therapeutic Uses

    • Type 2 Diabetes: Used to improve glycemic control in clients with type 2 diabetes by increasing glucose excretion in the urine.

    Side Effects & Adverse Reactions

    • Urinary Tract Infections: These infections can occur due to increased glucose in the urine, which provides a favorable environment for certain bacteria.
    • Genital Fungal Infections: These infections, particularly affecting females, can be complicated to treat and stem from increased glucose in the urine.
    • Orthostatic Hypotension: This drop in blood pressure with position change can also involve dizziness, especially in older adults and when used with diuretics.

    SGLT-2 Inhibitors: Precautions and Contraindications

    • Caution is advised for clients with severe renal impairment or those on dialysis as SGLT-2 inhibitors are less effective in individuals with impaired kidney function.
    • Contraindicated in individuals with an estimated glomerular filtration rate (GFR) below 45 mL/min/1.73 m2.

    Drug Interactions

    • Administering SGLT-2 inhibitors with UDP-glucuronosyltransferase inducers (such as rifampin, phenytoin, or phenobarbital) may require increased doses of the SGLT-2 inhibitor
    • Co-administration with thiazide and loop diuretics can increase the risk of dehydration and hypotension, due to the diuretic effect of SGLT-2 inhibitors

    Dosing, Administration & Client Teaching

    • Dosing varies based on the condition, severity, and client response
    • Check drug dosing guidelines for individualized dosing
    • Oral dosing once per day before the first meal
    • Not recommended for clients with severely impaired kidney function
    • Dosing is based on glycemic control needs and renal function
    • These drugs can be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia
    • These medications can also be used in clients who also have a history of ASCVD, heart failure, or CKD
    • PO administration
    • Clients should regularly monitor their blood glucose levels to avoid hypoglycemia
    • Clients should be educated on recognizing the signs and symptoms of hypoglycemia and how to manage it should it occur
    • Educate clients about hydration and monitoring for signs of infections or hypotension

    Labs to Monitor

    • Regular monitoring of kidney function and blood glucose levels is recommended to adjust dosing accordingly
    • Monitoring hemoglobin A1c will provide information on the effectiveness of the treatment regimen

    Prototype: Canagliflozin (Invokana)

    • Category: Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors (Oral Hypoglycemic Agent)
    • Primary Function: SGLT-2 inhibitors lower blood glucose levels in adults with type 2 diabetes by promoting glucose excretion in the urine. They can also be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia.
    • Unique Features: Glycosuria from SGLT-2 inhibitors can also cause weight loss.

    Mechanism of Action

    • SGLT-2 inhibitors work by blocking the reabsorption of glucose in the kidneys
    • By targeting the SGLT-2 transporter in the kidneys, responsible for approximately 90% of glucose reabsorption, SGLT-2 inhibitors facilitate increased urinary glucose excretion, thereby improving glycemic control and offering the added benefit of weight loss due to caloric loss.

    Indications and Therapeutic Uses

    • Diabetes: SGLT-2 inhibitors are utilized to improve glycemic control in clients with type 2 diabetes by increasing glucose excretion in the urine.

    Side Effects and Adverse Reactions

    Side Effect Description
    Urinary Tract Infections These infections are caused by increased glucose in the urine since certain bacteria thrive in those conditions.
    Genital Fungal Infections These infections can be complicated to treat and stem from increased glucose in the urine. Females are particularly affected.
    Orthostatic Hypotension This drop in blood pressure occurs with position change and can also involve dizziness, especially in older adults and when used with diuretics.

    Precautions

    • Caution is advised for clients with severe renal impairment or on dialysis, as SGLT-2 inhibitors are less effective in individuals with impaired kidney function.

    Contraindications

    • Contraindicated in individuals with an estimated glomerular filtration rate (GFR) below 45 mL/min/1.73 m2.

    Drug Interactions

    • Administering SGLT-2 inhibitors with UDP-glucuronosyltransferase inducers (such as rifampin, phenytoin, or phenobarbital) may require increased doses of the SGLT-2 inhibitor.
    • Since SGLT-2 inhibitors can cause a diuretic effect, co-administration with thiazide and loop diuretics can increase the risk of dehydration and hypotension.

    Dosing

    • Dosing varies based on the condition, severity, and client response.
    • Check drug dosing guidelines for individualized dosing.
    • Oral dosing once per day before the first meal.
    • Not recommended for clients with severely impaired kidney function.
    • Dosing is based on glycemic control needs and renal function.
    • These drugs can be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia.
    • These medications can also be used in clients who also have a history of ASCVD, heart failure, or CKD.

    Administration

    • PO administration.

    Client Teaching

    • Clients should regularly monitor their blood glucose levels to avoid hypoglycemia.
    • Clients should be educated on recognizing the signs and symptoms of hypoglycemia and how to manage it should it occur.
    • Educate clients about hydration and monitoring for signs of infections or hypotension.

    Labs to Monitor

    • Regularly monitor kidney function and blood glucose levels to adjust dosing.
    • Monitoring hemoglobin A1c will provide information on the effectiveness of the treatment regimen.

    Prototype: canagliflozin (Invokana)

    • Category: Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors (Oral Hypoglycemic Agent)
    • Primary Function: SGLT-2 inhibitors lower blood glucose levels in adults with type 2 diabetes by promoting glucose excretion in the urine. They can also be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia.
    • Unique Features: Glycosuria from SGLT-2 inhibitors can also cause weight loss.

    Mechanism of Action

    • SGLT-2 inhibitors work by blocking the reabsorption of glucose in the kidneys. By targeting the SGLT-2 transporter in the kidneys, responsible for approximately 90% of glucose reabsorption, these inhibitors facilitate increased urinary glucose excretion, thereby improving glycemic control and offering the added benefit of weight loss due to caloric loss.

    Indications and Therapeutic Uses

    • Diabetes: SGLT-2 inhibitors are utilized to improve glycemic control in clients with type 2 diabetes by increasing glucose excretion in the urine.

    Side Effects and Adverse Reactions

    • Urinary Tract Infections: Increased glucose in the urine can lead to these infections, as certain bacteria thrive in these conditions.
    • Genital Fungal Infections: Increased glucose in the urine can contribute to these infections, which can be difficult to treat. Females are particularly affected.
    • Orthostatic Hypotension: This drop in blood pressure occurs with position change and can also involve dizziness, especially in older adults and when used with diuretics.

    Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors

    • Canagliflozin (Invokana) is a Sodium-Glucose Cotransporter-2 inhibitor.
    • SGLT-2 inhibitors are oral hypoglycemic agents.
    • SGLT-2 Inhibitors lower blood glucose by increasing the excretion of glucose in urine.
    • SGLT-2 Inhibitors can also be used to treat overweight patients with type 2 diabetes.
    • SGLT-2 inhibitors are also used to manage patients with a high risk for hypoglycemia.
    • SGLT-2 Inhibitors are used in addition to diet and exercise.
    • SGLT-2 inhibitors can cause weight loss in patients.
    • Other SGLT-2 inhibitors include Bexagliflozin, Dapagliflozin, Empagliflozin and Ertugliflozin.

    Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors

    • Canagliflozin (Invokana) is an oral hypoglycemic agent, part of the SGLT-2 inhibitor class.
    • SGLT-2 inhibitors work by promoting glucose excretion in the urine, which lowers blood glucose levels in adults with type 2 diabetes.
    • They can be added to the treatment regimen of clients who are overweight or have a risk of hypoglycemia
    • One unique feature of SGLT-2 inhibitors is that they cause glycosuria, which can lead to weight loss.
    • Other examples of drugs in this class include Bexagliflozin (Brenzavvy), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), and Ertugliflozin (Steglatro).

    Canagliflozin (Invokana)

    • Canagliflozin is part of the Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitor drug class
    • This class of drugs are oral hypoglycemic agents used to treat type 2 diabetes.
    • SGLT-2 inhibitors work by increasing glucose excretion in urine which lowers blood glucose levels.
    • Canagliflozin can be used in people with type 2 diabetes that are overweight or at risk of hypoglycemia.
    • Canagliflozin may lead to weight loss due to increased glucose excretion in urine.

    Other SGLT-2 Inhibitors

    • Other medications in this class include:
      • Bexagliflozin (Brenzavvy™)
      • Dapagliflozin (Farxiga®)
      • Empagliflozin (Jardiance®)
      • Ertugliflozin (Steglatro®)

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    Related Documents

    SGLT-2 Inhibitors for Type 2 Diabetes PDF
    Canagliflozin (Invokana) - SGLT-2 Inhibitors

    Description

    This quiz covers the important precautions and contraindications associated with SGLT-2 inhibitors, particularly in patients with renal impairment. It also addresses drug interactions and dosing guidelines for effective administration. Perfect for healthcare professionals looking to refresh their knowledge on this class of medication.

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