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29 Cards in this Set

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Which oral hypoglycemic drugs:

- oldest and largest group
- may be used alone or in combination with other hypoglycemic drugs
- always give with breakfast to prevent nighttime hypoglycemia
- check BS before administration
- started at low doses and gradually increased for FBS = 110 mg/dL
Sulfonylureas
Which oral hypoglycemic drugs:

- stimulates the release of insulin from the pancreas
- increases tissue response to insulin
Sulfonylureas
Which oral hypoglycemic drugs:

(2nd generation):

- glimepride (Amaryl)
- glipizide (Glucotrol)
- glyburide (Diabeta)
Sulfonylureas
Which oral hypoglycemic drugs:

Distribution: 90% protein bound
Sulfonylureas
Which oral hypoglycemic drugs:

Adverse effects:

- hypoglycemia
- may cause weight gain
- GI upset
Sulfonylureas
Which oral hypoglycemic drugs:

Contraindicated:

- hypersensitivity
- renal/hepatic impairment
- pregnancy
Sulfonylureas
Which oral hypoglycemic drugs:

- doesn't cause hypoglycemia
- used alone or in combo
- taken with meals
- always stop drug for 48 hours for any client receiving IV contrast
Biguanides
Which oral hypoglycemic drugs:

- decreases glucose production from liver
- decreases intestinal absorption of glucose, & enhances glucose uptake in peripheral tissues
Biguanides
Which oral hypoglycemic drugs:

- metformin (Glucophage, Glucophage XR)
Biguanides
Which oral hypoglycemic drugs:

- excreted unchanged by kidneys
Biguanides
Which oral hypoglycemic drug:

Adverse effects:

- decreased appetite, nausea, diarrhea
- clients usually lose weight
- decreased GI absorption of B12 & folate
- lactic acidosis
Biguanides
Which oral hypoglycemic drug:

Contraindications:

- pregnancy
- renal/hepatic impairment
- cardiac disease
Biguanides
Which oral hypoglycemic drug:

- may be used alone or combo with insulin, sulfonyureas, metformin
- does not cause hypoglycemia
- take with first bite of each main meal
- start at low doses and gradually increase (decrease GI upset)
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

- Delays glucose absorption in the GI tract; reducing rise in BS levels following a meal
- Delays absorption of dietary carbs
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

- acarbose (Precose)
- miglitol (Glyset)
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

- metabolized in GI tract by digestive enzymes and intestinal bacteria
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

Adverse effects:

- flatulence
- abdominal distention
- diarrhea
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

Contraindicated:

- hypersensitivity
- DKA
- hepatic cirrhosis
- inflammatory or malabsorptive intestinal disorders
- renal impairment
Alpha-Glucosidase Inhibitors
Which oral hypoglycemic drug:

- may take several weeks to see effects
- monitor LFT
- may be taken without regard to meals
- may be used alone or in combo with insulin, sulfonylureas, metformin
Glitazones (Thiazolidinediones)
Which oral hypoglycemic drug:

- rosiglitazone (Avandia)
- pioplitazone (Actos)
Glitazones (Thiazolidinediones)
Which oral hypoglycemic drug:

- decreases insulin resistance
- increases the ability of target cells to respond to insulin
Glitazones (Thiazolidinediones)
Which oral hypoglycemic drug:

Adverse effects:

- fluid retention
- hepatotoxicity
- URI
- weight gain
Glitazones (Thiazolidinediones)
Which oral hypoglycemic drug:

Contraindications:

- use caution with HF
- use caution with insulin
Glitazones (Thiazolidinediones)
Which oral hypoglycemic drug:

- may be used alone or in combo with metformin
- take up to 30 min before a meal
- if meal is skipped -> skip drug
Meglitinides
Which oral hypoglycemic drug:

- stimulates pancreatic secretion of insulin
Meglitinides
Which oral hypoglycemic drug:

- mateglinide (Starlix)
- repaglinde (Prandin)
Meglitinides
Which oral hypoglycemic drug:

Adverse effects:

- hypoglycemia
- rhinitis
- respiratory infections
Meglitinides
Which oral hypoglycemic drug:

- SC route before am and pm meals
- synthetic form of the saliva found in the Gila monster lizard
- approved by FDA in April 2005
Exenatide (Byetta)
Which oral hypoglycemic drug:

Adverse effects:

- nausea
- hypoglycemia
Exenatide (Byetta)