Diabetic Meds

Front 1

Sulfonylureas
Tolbutamide (Orinase)
Glipizide (Glucotrol)
Glyburide (Micronase)

Back 1

Can only be used with Type 2 Diabetics.
May be used alone or in combo with other hypoglycemic agents.
Duration of action will determine how often the meds need to be taken.
Should be used with caution in the elderly due to renal excretion (may need lower dose).
Should be taken 30 minutes prior to eating.

Front 2

Meglitinides
Repanglinide (Prandin)
Nateglinide (Starlix)

Back 2

Can only be used with Type 2 Diabetics.
Same mechanism of action as Sulfonylureas so patients who don’t respond to one won’t respond to the other.
Has very short half life so hypoglycemia is minimized if a meal is skipped or delayed.
Should be taken 15-30 minutes before meals.

Front 3

Biguanides
Metformin (Glucophage)

Back 3

Can only be used with Type 2 diabetics.
Should not be given to patients with kidney problems due to fact that is it excreted unchanged by the kidneys.
May be given with Sulfonylureas.
Able to reduce blood sugar in patients who are no longer producing any insulin.
Should not be used in patients with liver disease, severe infection, a history of lactic acidosis, alcoholics, patients in shock or conditions with hypoxemia because it causes lactic acidosis.
Use of medication in patients with heart failure controversial.
GI effects can be decreased by taking with meals.
Should not be taken 48 hours before any procedure that uses contrast dye-may result in renal failure

Front 4

Thiazolidinediones
Rosiglitazone (Avandia)
Pioglitazone (Actos)

Back 4

Used for patients with Type 2 Diabetes.
Should be given with caution in patients with heart failure due to expanded blood volume and edema.
May be liver toxic so LFTs must be carefully monitored.
Can be taken without regards for meals.

Front 5

Alpha-Glucosidase Inhibitors
Acarbose (Precose)
Miglitol (Glyset)

Back 5

Used to treat Type 2 Diabetics.
May be used alone or in combo with other agents.
When used alone does not usually cause hypoglycemia.
May cause liver disease-monitor LFTs.
Should not be used in combo with Metformin due to GI effects.
Should take with first bite of food.

Front 6

Combination Meds (usually some med combined with Metformin)
Glucovance (combo Glyburide and Metformin)
Metaglip (combo for Glipizide and Metformin)
Avandamet (combo for Rosiglitazone and Metformin)

Back 6

Nursing considerations would be the same as for the individual drugs

Front 7

Amylin Mimetics
Pramlintide (Symlin)

Back 7

Used as a supplement to Type 1 or type 2 diabetics who are having trouble with glucose control.
May delay the absorption of other oral drugs.
Administer other oral drugs one hour before or two hours after giving symlin.
Should monitor HbA1C and BS.

Front 8

Incretin mimetics
Exenatide (Byetta)

Back 8

Improves glucose control in Type 2 patients taking metformin, sulfonylurea or both.
Should not be used in patients with end stage renal disease since the kidney will not clear the medicine.
Due to delayed gastric emptying should not be given at the same time as other oral meds (especially antibiotics and oral contraceptives)
Given as a SC injection with a medication pen.
Should monitor HbA1C and BS.