NSG 170 Oral Hypoglycemic Medications PDF

**Oral hypoglycemic medications** +-------------+-------------+-------------+-------------+-------------+ | **Drug | **How drug | **Usual | **Major | **Nursing | | class** | works** | dose** | side | implication | | | | | effec...

**Oral hypoglycemic medications** +-------------+-------------+-------------+-------------+-------------+ | **Drug | **How drug | **Usual | **Major | **Nursing | | class** | works** | dose** | side | implication | | | | | effect(s)** | s** | | **Prototype | | **When is | | | | drug** | | it taken** | | | +=============+=============+=============+=============+=============+ | Biguanide: | Reduces | 500 mg BID; | Anorexia. | Effects | | metformin | glucose | may be | Nausea, | usually | | | production | increased | diarrhea | subside | | | in the | to 1000 -- | | with use | | | liver | 2550 mg in | Vitamin B12 | | | | | 2 -- 3 | and folic | Assess for | | | Increases | divided | acid | severity | | | glucose | doses. | deficiency | | | | uptake in | | D/T altered | D/C med if | | | fat and | Take | absorption | necessary | | | skeletal | immediate | | | | | muscles | release | Lactic | Provide | | | | tabs with | acidosis -- | supplements | | | Decreases | breakfast | rare but | as needed | | | glucose | and evening | potentially | | | | absorption | meal | fatal | Encourage | | | in GI tract | | adverse | client to | | | | Take | effect. | drink | | | 1^st^ | sustained | Increased | plenty of | | | choice of | release | risk in | fluid after | | | medication | tablets | clients | contrast | | | for T2D | once daily | with renal | dye | | | | | dysfunction | | | | | | or when IV | Hold | | | | | contrast | metformin | | | | | dye is | for 48 | | | | | used. | hours after | | | | | | X-ray study | | | | | | | | | | | | Clients | | | | | | with renal | | | | | | dysfunction | | | | | | should not | | | | | | use | | | | | | metformin | +-------------+-------------+-------------+-------------+-------------+ | Thiazolidin | Increases | Pioglitazon | Fluid | Contraindic | | edione: | cellular | e | retention, | ated | | | response to | -- 15-30 | headache, | in clients | | pioglitazon | insulin by | mg/day | weight gain | with heart | | e, | decreasing | | | failure | | rosiglitazo | insulin | Take with | May be | | | ne | resistance | or without | hepatotoxic | Assess | | | | food | | liver | | | Increases | | Elevated | function | | | glucose | Rosiglitazo | LDL | before | | | uptake and | ne | cholesterol | starting | | | decreases | -- 2 -- 4 | | drug and | | | glucose | mg one or | | periodicall | | | production | two times | | y | | | | daily | | throughout | | | Optimal | | | therapy | | | lowering of | | | | | | BG may take | | | Monitor | | | 3 -- 4 | | | cholesterol | | | months | | | levels | +-------------+-------------+-------------+-------------+-------------+ +-------------+-------------+-------------+-------------+-------------+ | Dipeptidyl | Augments | 100 mg | Flu-like | Teach | | peptidase 4 | naturally | daily | symptoms, | clients to | | (DPP-4) | occurring | | upper | report | | inhibitor: | incretin | Take with | respiratory | signs of | | sitagliptin | hormones | or without | infection, | infection | | | (promote | food | back pain | to HCP | | | release of | | | | | | insulin; | | | | | | decrease | | | | | | production | | | | | | of | | | | | | glucagon) | | | | | | | | | | | | Lowers | | | | | | fasting and | | | | | | PP glucose | | | | | | levels | | | | +=============+=============+=============+=============+=============+ | Sodium-gluc | Used in | 100 mg | Cystitis, | Monitor for | | ose | combination | initial | candidiasis | signs of | | cotransport | with | dose; may | , | infection | | er | insulin for | be | and | | | | T1D | increased | polyuria | Orthostatic | | (SGLT2) | | to 300 mg | | precautions | | inhibitor: | Limits rise | | Dizziness | | | canaglifloz | of PP | Take once | and risk | Use caution | | in | glucose | daily | for | if given | | | | before | hypotension | with | | | Excretes | breakfast | -- | diuretics | | | glucose | | especially | | | | through | | in older | | | | urine | | adults if | | | | | | used with | | | | Promotes | | diuretics | | | | weight loss | | | | +-------------+-------------+-------------+-------------+-------------+ | Glucagon-li | Promotes | 5 mcg | Nausea, | Notify HCP | | ke | release of | initial | vomiting, | if Sx are | | peptide-1 | insulin, | dose; may | diarrhea | intolerable | | (GLP-1) | decreases | be | | | | agonist: | release of | increased | Pancreatiti | Withhold | | exenatide | glucagon, | to 10 mcg | s | medication | | (Byetta) | slows | | (severe | and notify | | | gastric | Administer | abdominal | HCP if Sx | | Semaglutide | emptying. | SC 60 min | and left | present | | (Ozempic, | Decreases | before | flank pain) | | | Wegovy) | fasting and | morning and | | Contraindic | | | PP blood | evening | | ated | | | glucose | meals | | in clients | | | | | | with renal | | | | | | failure | +-------------+-------------+-------------+-------------+-------------+ | Sulfonylure | Insulin | Glimepiride | Hypoglycemi | Monitor for | | a: | release | -- 1 -- 4 | a | hypoglycemi | | glimepiride | from | mg per day | | a | | , | pancreas; | | Weight gain | | | | increase | Glipizide | | Ensure | | glipizide, | tissue | -- 2.5 -- | | client | | glyburide | sensitivity | 20 mg 1 -- | | knows how | | | to insulin | 2 times per | | to | | | | day | | recognize | | | | | | and treat | | | | Take 30 | | hypoglycemi | | | | minutes | | a | | | | before | | orally or | | | | breakfast; | | that | | | | hold dose | | glucagon is | | | | if client | | available | | | | is unable | | | | | | to eat. | | Adhere to | | | | | | proper diet | | | | Glyburide | | and | | | | -- 1.5 -- | | increase | | | | 10 mg 1 -- | | physical | | | | 2 times per | | activity | | | | day | | | +-------------+-------------+-------------+-------------+-------------+ | Amylin | Mimics the | T2D | Nausea | Report to | | mimetic: | action of | | | HCP; dose | | pramlintide | the hormone | 60 mcg SC | Injection | may be | | | amylin to | before | site | lowered | | | decrease | meals; may | reactions | | | | gastric | increase to | | Usually | | | emptying | 120 mcg SC | | self | | | time and | before | | limiting | | | inhibit | meals | | | | | secretion | | | Contraindic | | | of | Give oral | | ated | | | glucagon. | medications | | in clients | | | Lowers PP | 1 -- 2 | | with renal | | | blood | hours after | | failure | | | glucose | pramlintide | | | | | levels | to prevent | | | | | | delayed | | | | | | absorption | | | | | | of oral | | | | | | meds | | | +-------------+-------------+-------------+-------------+-------------+ | Alpha-gluco | Slows | 25 mg PO | Abdominal | Assess | | sidase | carbohydrat | Q8hrs with | distention, | impact of | | inhibitor: | e | first bite | hyperactive | symptoms on | | acarbose | absorption | of food | bowel | client | | | and | | sounds, | | | | digestion | May | diarrhea, | DC med if | | | | increase to | excessive | necessary | | | | 50 -- 100 | gas | | | | | mg PO Q8hrs | | Monitor hgb | | | | with first | Anemia due | & hct | | | | bite of | to | | | | | food | decreased | | | | | | iron | | | | | | absorption | | +-------------+-------------+-------------+-------------+-------------+ | Meglitinide | Insulin | 0.5 -- 4 mg | Hypoglycemi | Monitor for | | s: | release | BID to QID | a | hypoglycemi | | repaglinide | from | | | a | | | pancreas | Give 1 -- | Weight gain | | | | | 30 minutes | | Ensure | | | | before | | client | | | | meals | | knows how | | | | | | to | | | | | | recognize | | | | | | and treat | | | | | | hypoglycemi | | | | | | a | | | | | | orally or | | | | | | that | | | | | | glucagon is | | | | | | available | | | | | | | | | | | | Adhere to | | | | | | proper diet | | | | | | and | | | | | | increase | | | | | | physical | | | | | | activity | +-------------+-------------+-------------+-------------+-------------+