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151 Cards in this Set
- Front
- Back
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Side Effects of Benzodiazapines |
Side Effects: Drowsiness, Sedation, Blurred vision, Hypotension, Blood dyscrasias, (Routine RBC/WBC) Needed NO ALCOHOL!
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Side Effects of Benzodiazapines
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Side Effects: Drowsiness, Sedation, Blurred vision, Hypotension, Blood dyscrasias, (Routine RBC/WBC) Needed NO ALCOHOL!
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Antidote for benzodiazapines
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Flumazenil (Romazicon)
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Antidote for benzodiazapines
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Flumazenil (Romazicon)
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Drug Interactions of benzodiazapines
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Antihistamines, analgesics, anesthetics, probenecid, tranquilizers, narcotics, cimetidine, oral contraceptives
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Drug Interactions of benzodiazapines
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Antihistamines, analgesics, anesthetics, probenecid, tranquilizers, narcotics, cimetidine, oral contraceptives
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Common Benzodiazapines
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Alprazolam (Xanax), Lorazepam (Ativan),
Diazepam (Valium)-prototype, Chlodiazepoxide (Librium), Clonazepam (Klonopin), Clorazepate( Tranxene), Oxazepam (serax) |
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Common Benzodiazapines
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Alprazolam (Xanax), Lorazepam (Ativan),
Diazepam (Valium)-prototype, Chlodiazepoxide (Librium), Clonazepam (Klonopin), Clorazepate( Tranxene), Oxazepam (serax) |
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Uses for Azaspirones
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Used for anxiety, smoking cessation, improved coping, OCD, panic disorder, PTSD
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Uses for Azaspirones
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Used for anxiety, smoking cessation, improved coping, OCD, panic disorder, PTSD
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Facts about Azaspirones
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No physical/psychological dependence.
Assess for side effects of CNS depression (slurred speech and dizziness) |
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Facts about Azaspirones
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No physical/psychological dependence.
Assess for side effects of CNS depression (slurred speech and dizziness) |
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Common Azaspirones
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Busiprone or BuSpar
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Common Azaspirones
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Busiprone or BuSpar
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Selective Serotonin Reuptake Inhibitors (SSRI)
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Fluoxetine (Prozac)- prototype
Escitalopram (Lexapro) Citalopram (Celexa) Fluvoxamine (Luvox) Paroxetine (Paxil) Sertraline (Zoloft) |
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Selective Serotonin Reuptake Inhibitors (SSRI)
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Fluoxetine (Prozac)- prototype
Escitalopram (Lexapro) Citalopram (Celexa) Fluvoxamine (Luvox) Paroxetine (Paxil) Sertraline (Zoloft) |
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Actions of SSRI's
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Intensify the effects of serotonin to improve mood.
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Actions of SSRI's
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Intensify the effects of serotonin to improve mood.
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Uses for SSRI's
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Treats: depression , OCD, panic, PTSD, eating disorder.
Newer class that inhibit reuptake of serotonin and norepinephrine- No anticholinergic or cardiac effects: Desvenlafaxine (Prestiq) Duloxetine (Cymbalta) Venlafaxine (Effexor) |
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Uses for SSRI's
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Treats: depression , OCD, panic, PTSD, eating disorder.
Newer class that inhibit reuptake of serotonin and norepinephrine- No anticholinergic or cardiac effects: Desvenlafaxine (Prestiq) Duloxetine (Cymbalta) Venlafaxine (Effexor) |
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Side effects of SSRI's
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Serotonin Syndrome
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Facts about SSRI's
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Most commonly prescribed antidepressant
Prozac reacts with many drugs and has a long half life. DO NOT take with MAOI’s or TCA’s Pregnancy risk category C |
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Common Tricyclic antidepressants
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Amitriptyline (Elavil)- Prototype
Clomipramine (Anafranil) Imipramine (Tofranil) Doxepin (Sinequan) Nortriptyline (Aventyl, Pamelor) Amoxapine Desipramine (Norpramin) Protriptyline (Vivactil) Trimipramine (Surmontil) |
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Uses for Tricyclic antidepressants
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Used in major depression.
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Action of Tricyclic antidepressants
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Block re-uptake of serotonin, norepinephrine, dopamine
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Facts about Tricyclic antidepressants
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Low therapeutic threshold; not for patient with suicidal thoughts.
Many drug interations! |
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Side Effects of Tricyclic antidepressants
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Anticholinergic (Constipation, dry mouth, decrease GI and bladder motility), hypotension, sedation
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Common Monoamine oxidase inhibitors (MAOI’s)
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Phenelzine (nardil)- prototype
Tranylcypromine (parnate) Isocarboxazid (Marplan) Selegiline (Emsam) |
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Uses for MAOI's
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Used for atypical depression
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Action of MAOI's
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Block destruction of epinephrine, norepinephrine, dopamine, and serotonin
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Side Effects of MAOI's
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Orthostatic hypotension- mostly with phenelzine than tranylcypromine, drowsiness, sedation, restlessness, agitation, insomnia, blurred vision, constipations, dry mucosa, urinary retention
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Dietary Restrictions of MAOI's
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Dietary restrictions- Avoid foods high in tyramine- causes hypertensive crisis
Do not administer with other antidepressants. Monitor blood glucose |
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Miscellaneous agents: Atypical Antidepressants
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Buproprion (Wellbutrin, Zyban)- Prototype
Mirtazapine (Remeron) Nefazodone (similar to trazadone) Trazadone |
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Uses for Miscellaneous agents: Atypical Antidepressants
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Buproprion- lowers seizure threshold, useful in smoking cessation
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Side Effects for Miscellaneous agents: Atypical Antidepressants
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Orthostatic hypotension, drowsiness, dysrhythmias, tachycardia, confusion, dizziness, lightheadedness
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Facts about Miscellaneous agents: Atypical Antidepressants
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Do not use Buproprion with nicotine replacement agents- may cause hypertension.
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Facts about Antidepresents
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All antidepressants can take 4-6; 6-8 weeks for full effect. Patients can be at a higher risk for suicide once feeling better. Do not abruptly stop could cause withdrawal symptoms.
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Drugs used for Bipolar disorder – Antimanic agents
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Lithium Carbonate (Eskalith, Eskalith CR, Lithobid) – 1st line drug treatment for mania
Cyclothymia- Used to treat milder form of bipolar illness |
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Uses for Antimanic agents
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Used to treat mania associated with bipolar disorder
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Side Effects Antimanic agents
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Sodium depletion enhances lithium toxicity
Take with food to decrease GI irritation |
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Facts about Antimanic agents
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With bipolar disorder you must treat depression and mania
With lithium carbonate you must monitor several blood studies- CBC with diff, thyroid, and kidney function. Anticonvulsants also used: Tegretol and depakote |
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Common Typical Antipsychotics
(1st generation) |
Chlorpromazine (Thorazine, Largactil)- Prototype
Thioridazine (mellaril) Fluphenazine (Prolixin, Moditen) Perphenaine Trifluoperazine Prochlorperazine (Compazine) Thiothixene (Navane) Haloperidol (Haldol) Loxapine (Loxapine) Molindone (Moban) |
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Uses of Typical Antipsychotics
(1st generation) |
Changed quality of life for many; stabilized psychosis and lead to improved quality of life. Good control of positive symptoms.
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Side Effects of Typical Antipsychotics
(1st generation) |
Photosensitivity, EPS (Extrapyramidal symptoms)- Akathisia, dystonia, psuedoparkinsonian, TD (Tardive Dyskinesia), Lowered seizure threshold, Sedation, hypotension, anticholinergic effects
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Facts about Typical Antipsychotics
(1st generation) |
1st antipsychotics available
Higher incidence of EPS (extrapyramidal symptoms) and eventually TD (Tardive Dyskinesia) Have been gradually replaced by newer drugs |
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Atypical Antipsychotics (2nd generation) Drugs
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Risperidone (Risperdal)-Prototype. Pregnancy risk category C (Olanzapine- Zyprexa, Quetiapine- Seroquel, Ziprasidone- Geodon, Aripiprazole- Abilify)
Clozapine (Clozaril)- Treatment failure requires frequent CBC to monitor for agranulocytosis. Dosage based on symptoms and labs |
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Atypical Antipsychotics (2nd generation) Facts
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Most widely used antipsychotic on the market. Less potential for EPS/TD. Known to cause metabolic disorders over time. BLACK BOX warning in elderly. Must monitor weight, glucose, fasting lipids routinely
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Atypical Antipsychotics (2nd generation) Side Effects
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Clozapine (Clozaril)- Can cause agranulocytosis which is life threatening.
Neuroleptic malignant syndrome, blood dyscrasias, metabolic syndrome, potential for Qt prolongation |
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Atypical Antipsychotics (2nd generation) Uses
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Also used to treat psychoses associated with mental illnesses such as schizophrenia, mania, psychotic depression, and psychotic organic brain syndrome.
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New Antipsychotics Atypicals on Market
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Asenapine (Saphris)- also used for bipolar disorder
Iloperidone (Fanapt)- used for acute schizophrenia Lurasidone (Latuda)-for schizophrenia Paliperidone (Invega, Invega Sustenna)- Used for Schizophrenia; adjunct mood stabilizer |
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Benzodiazepines as anticonvulsant drugs
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Diazepam (Valium)-Prototype
Clonazepam (Klonopin) Clorazepate (Tranxene) Lorazepam (Ativan) |
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Benzodiazepines as anticonvulsant uses
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Anticonvulsants. Reduced frequency of seizures and reduced injury from seizure activity
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Benzodiazepines as anticonvulsant side effects
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Sedation, drowsiness, dizziness, fatigue, lethargy, blurred vision, behavioral disturbances, blood dyscrasias, hepatotoxicity
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Benzodiazepines as anticonvulsant interactions
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Minimal adverse effects.
Avoid smoking |
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Hydantoins Common drugs
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Phenytoin (Dilantin)- Prototype (Therapeutic level- 10-20 mg/L)
Ethotoin (Peganone) Fosphenytoin (Cerebyx) |
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Hydantoins Important Info
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Administer with food or milk to reduce GI upset.
Monitor patients with concurrent therapy for signs of phenytoin toxicity: nystagmus), sedation, or lethargy |
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Hydantoins Side Effects
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Nausea, vomiting, indigestion, sedation, drowsiness, dizziness, fatigue, lethargy, confusion, blurred vision, gingival hyperplasia, hyperglycemia, blood dyscrasias, hepatotoxicity, dermatologic reactions
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Hydantoins Uses
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Control partial (psychomotor) seizures and generalized tonic-clonic seizures.
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Succinimides Common Drugs
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Ethosuximide (Zarontin)
Methsuximide (Celontin) |
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Succinimides therapudic levels
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Tegretol- Therapeutic level 4-12 mg/L (Not for south Asian Indians, lethal consequences)
Neurotin- Therapeutic level 12-20 mg/L Lamictal- Therapeutic level 3-14 mg/L Keppra- Therapeutic level 10-40 mg/L Trileptal- Therapeutic level 3-40 mg/L Topamax- Therapeutic level 2-25 mg/L Depakote- Therapeutic level 40-100 mg/L Zonegran- Therapeutic level 10-40 mg/L Luminal- Therapeutic drug level 15-45 mg/L |
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Side Effects for Succinimides
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Nausea, vomiting, indigestion, sedation, drowsiness, dizziness, fatigue, lethargy
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Uses for Succinimides
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Used to treat absence (petit mal) seizures
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Teaching for Anti Convulsant Meds
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Patient Teaching:
Take meds a prescribed, importance of routine labs, report bruising rash bleeding jaundice immediately, avoid alcohol caffeine and grapefruit juice, avoid OTC meds, keep drug and seizure record, wear a medi-alert bracelet |
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Common Statins
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Lipophilic
Lipitor Zocor Mevacor Lescol Hydrophilic Crestor Pravachol Livola Triglycerides |
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Statin Nursing Considerations
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Pregnancy category X, monitor liver function, administer before bed with low fat snack, teach signs and symptoms of myopathy, Teach importance of follow up labs. Interacts with strong metabolic inhibitors- antifungals, check elecrolytes, NO GRAPEFRUT!!! Assess for pregnancy
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Statin Side Effects
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May raise liver enzymes, Myopathy, GI upset
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Uses for Statins
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Blocks enzyme that liver needs to manufacture cholesterol, Lowers liver cholesterol by removal of LDL from circulating blood, decreases inflammation of blood vessels, lowers platelet aggregation, lowers thrombin formation, lowers plasma viscosity, REDUCES RISK FACTOR OF HEART ATTACK AND STROKES
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Niacin- B3 Nicotonic acid Uses
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Inhibits VLDL synthesis which lowers LDL and triglyceride production, lowers total cholesterol and LDL, Raises HDL, Causes release of histamine causing vasodialation and skin flushing
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Niacin- B3 Nicotonic acid Side Effects
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Flushing, itching, rash, tingling, hypotension, GI upset
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Niacin- B3 Nicotonic acid Nursing Considerations
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Take ASA or NSAID 30 min before niacin dose, Antihistamines may reduce reaction and rash, give with food, teach to rise slowly and monitor BP, administer 4-6 hours before bile acid suquestrants, Avoid giving with alcohol, unstable angina or MI, diabetes, renal disease, gout, past hepatic disease, with anticoagulants
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Common Fenofibrates
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Gemfibrozil (Lopid)
Fenofibric Acid (Tricor) |
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Side Effects of Fenofibrates
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GI upset, Myopathy, Cholelithiasis (gallstones), hyperglycemia
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Uses for Fenofibrates
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Lowers triglycerides, raises HDL, lowers LDL
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Nursing Considerations for Fenofibrates
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Teach signs/symptoms of myopathy, Check liver function, Monitor diabetics for bs up, Teach f/u labs, Reacts with Wrfarin, sulfonylureas
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Common Bile Acid Resins
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Cholestyramine (Questran)
Colestipol (Colestid) Colesevelam (Welchol |
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Uses for Bile Acid Resins
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Cause liver to raised metabolism of cholesterol to produce more bile acids, Lowers LDL Raises HDL, May raise triglycerides
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Nursing Considerations for Bile Acid Resins
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Safe and efficacious, teach to mix powder form with juices or fruits high in moisture (applesauce), monitor for vitamin deficiency Vitamin K (bleeding), Administer oral meds 1 hour before or 4 hours after, Do not give to patients on amiodorone
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Side Effects with Bile Acid Resins
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Abdominal pain, nausea and vomiting, distention, flatulence, constipation, decrease absorption of fat-soluble vitamins, alters absorption of other oral meds
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Common Intestinal cholesterol absorption inhibitors
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Ezetimibe (Zetia)
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Uses for Intestinal cholesterol absorption inhibitors
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Blocks absorption of cholesterol by small intestine
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Side effects of Intestinal cholesterol absorption inhibitors
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Mild GI Upset
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Common Diuretics
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Lasix (furosemide)- loop
Hydrochlorothiazide (HCTZ)- thiazide |
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Uses for Diuretics
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Used in all stages, potentiate hypotensive actions of other anti-hypertensive agents, low adverse effects, reduces fluid volume, reduces sodium, vasodialation
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Side Effects Diuretics
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Electrolyte depletion (K+ & Na+), dehydration
Check electrolytes and I&O |
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Nursing Considerations for Diuretics
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Thiazide & thiazide-like diuretics- used if adequate renal function
Loop diuretics- Strongest Carbonic anhydrase inhibitor- Wimpy Potassium sparing diuretics- Used in combo c thiazide and loop diuretics |
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Common Beta-adrenergic blockers- “olol”
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Cebutolol (Sectral)
Tenolol (Tenormin) Etaxolol (Kerlone) Isoprolol (Zebeta ) Arvedilol (Coreg) Smolol (Breviblock) Abetalol (Trandate) Etoprolol (Tropol, Lopressor) Adolol (Congard) Evivolol (Bystolic) Indolol (Visken HTN) Propranolol (Inderal) |
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Uses for Beta-adrenergic blockers- “olol”
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Prevent MI; Atrial fib/ flutter, hypertrophic subaortic stenosis; migraines, angina. Inhibits cardiac response to sympathetic nerve stimulation by blocking beta receptors
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Nursing Considerations for Beta-adrenergic blockers- “olol”
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Bradycardia, fatigue, impotence, vasoconstriction (mottled skin), bronchospasm, Angina if d/c suddenly
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Side effects for Beta-adrenergic blockers- “olol”
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Do not use with asthma meds, if type one diabetic, heart failure caused by systolic dysfunction, PVD, Teach to not stop suddenly, May cause hypoglycemia, check interactions, NSAIDs may cause decreased effectiveness, not as effective in African Americans
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Commmon ACE Inhibitors- “pril”
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Benzapril (Lotensin)
Oexipril (Univasc) Captopril (Capoten) Enalapril (Vasotec) |
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uses for ACE Inhibitors- “pril”
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Inibits angiotensin I- converting enzyme, Prevents vasoconstriction, used in stage 1& 2 HTN; heart failure, lowers BP, preserves CO, increases renal blood flow
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Side Effects with ACE Inhibitors- “pril”
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Cough (1/3 patients), possible hyperkalemia (inhibits aldosterone), Angioedema (swelling of face, lips, and tongue)
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Nursing Considerations with ACE Inhibitors- “pril”
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Check electrolytes (K+), safety, if develop angioedema d/c and notify dr. immediately, not as effective in African Americans (unless combined with diuretic), Contraindicated in pregnancy
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Common Angiotensin II Receptor Blockers ARBs- “sartan”
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Andesartan (Atacand)
Prosartan (Teveten) Rbesartan (Avapro) Alsartan (Diovan) |
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Uses for Angiotensin II Receptor Blockers ARBs- “sartan”
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Bind to antiotensin II receptor sites (prevents vasoconstriction, used for HTN, heart failure, and post MI Lt ventricular dysfunction
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Side Effects of Angiotensin II Receptor Blockers ARBs- “sartan”
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Hyperkalemia, orthostasis
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Nursing Considerations for Angiotensin II Receptor Blockers ARBs- “sartan”
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Check electrolytes (K+), safety, check for pregnancy, not as effective in African Americans
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Common Calcium Channel Blockers (CCBs) Calcium Ion antagonists
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Diphenylalkylamine- Calan, Isoptin (verapamil)
Benzothiazelines- Cardizem (diltiazem) Dihydropyridine- dipines |
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Uses for Calcium Channel Blockers (CCBs) Calcium Ion antagonists
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Inhibits Ca++ ions movement across cell membrane, lowers conduction (fewer dysrhythmias), lowers heart rate, vasodilation
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Nursing Considerations for Calcium Channel Blockers (CCBs) Calcium Ion antagonists
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Classified by structure
VERY EFFECTIVE in African Americans and older patients |
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Common Dihydropyridine CCBs- “dipines”
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Amlodipine (Norvasc)
Clevidipine (Cleviprex) Felodipine (Pendil) Isradipine (DynaCirc) Nicardipine (Cardene) Nifedipine (Procardia) Nisoldipine (Sular) |
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Uses for Dihydropyridine CCBs- “dipines”
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Patients with higher pretreatment for HTN, Works well for patients with HTN + angina, alternative to beta blockers for patients with asthma
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Side Effects Dihydropyridine CCBs- “dipines”
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Edema
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Nursing Considerations for Dihydropyridine CCBs- “dipines”
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Better peripheral vasodilation, lower afterload, raised renal sodium secretion, well tolerated, check for edema, sodium levels, take daily weights
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Uses for Calcium Channel Blockers
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Used for hypertension, chronic stable angina, atrial fib/flutter, PSVT Paroxysmal supraventricular tachycardia
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Common Calcium Channel Blockers
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Verapamil
Diltiazem |
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Uses for Direct Renin Inhibitor
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Inhibits 1st step of renin-angiotensin-aldosterone system, prevents angiotensin II from activating it’s receptors, used for stage 1 and 2 hypertension and to lower BP
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Common Direct Renin Inhibitor
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Tekturna (aliskiren)
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Common Aldosterone Receptor Antagonists
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Inspra (eplerenone)
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Uses for Aldosterone Receptor Antagonists
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Blocks aldosterone which causes Na+ retention, prevents Na+ reabsorption, used for stages 1 and 2 hypertension and heart failure
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Side effects Aldosterone Receptor Antagonists
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Hypertriglyceridemia (1-15%)
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Nursing Considerations Aldosterone Receptor Antagonists
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Contraindications:
Hyperkalemia, renal or hepatic impairment, Type 2 diabetes with microalbuminuria, potassium-sparing diuretics, strong metabolic inhibitors, No grapefruit juice, check electrolytes, NSAIDs lower effectivness |
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Uses for Alpha-1 blocking agents- “zosin”
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Blocks post-synaptic alpha-1 adrenergic receptors to produce arteriolar and venous vasodilation, used for hypertension and BPH
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Side Effects for Alpha-1 blocking agents- “zosin”
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Drowsiness; dizziness (self-limiting)
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Nursing Considerations Alpha-1 blocking agents- “zosin”
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Doxazosin and terazosin lower urinary outflow resistance with the BPH- prostate and areas of bladder have alpha-1 receptors, Administer with food to lower side effects, avoid alcohol, give minipress with diuretic
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Common Alpha-1 blocking agents- “zosin”
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Doxazosin (Cardura)
Prazosin (Minipress) Terazosin (Hytrin) |
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Uses for Central acting alpha-2 agonists
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Stimulate alpha-adrenergic receptors in brain stem- decreased sympathetic outflow from brain, lowers HR and PVR (Peripheral vascular resistance), Used when other drugs fail and in the elderly.
Off Label uses: Heroine or nicotine withdrawal; alcohol dependence, severe pain, menopause, migraine, glaucoma, ADHD |
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Side Effects for Central acting alpha-2 agonists
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Sedation and fatigue, dizziness, dry mouth, depression, sexual dysfunction
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Nursing Considerations for Central acting alpha-2 agonists
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Assess mental status, teach do not suddenly d/c will cause profound rebound HTN, Patch form: can cause rash
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Common Central acting alpha-2 agonists
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Clonidine (Catapres, Catapres-TTS)
Guanabenz (Wytensin) Guanfacine (Tenex) Methyldopa |
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Uses for Direct Vasodilators
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Hydralazine (Apresoline)
Actions: Arterial smooth muscle dilator, lowers peripheral resistance, causes reflex tachycardia Uses: Severe HTN (Stage II) Renal disease, toxemia of pregnancy, heart failure, combined with beta blocker and diuretic |
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Common Direct Vasodilators
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Hydralazine (Apresoline)
Minoxidil (Loniten) Nitroprusside Sodium (Nipride) |
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Uses for Biguanides
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Lowers hepatic glucose production, reduces absorption of glucose from small intestine, increases insulin sensitivity in tissue
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Side Effects with Biguanides
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Nausea, vomiting, abdominal cramps, flatulence, myalgia, lactic acidosis (Rare)- if altered renal function, poor circulation, excessive alcohol intake is present
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Nursing Considerations for Biguanides
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Does not cause hypoglycemia, may cause weight loss, favorable effect on triglycerides, LDL, and HDL, administer with meals
Contraindications: Renal insufficiency with creatinine clearance, heart failure, sepsis, shock, decreased liver function, and IV radiopaque dyes (hold 24-48 hrs before procedures and 2-3 days after), Hold for elevated liver function tests, hold prior to surgery, BMP should be checked after 2-6 weeks |
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Common Biguanides
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Metfomin (Glucophage)
500-2500 mg daily |
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Side Effects of Sulfonylureas
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Hypoglycemia
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Nursing Considerations for Sulfonylureas
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Contraindications & interactions: Hepatic disease, sulfa allergy, pregnancy, Alcohol, Beta blockers
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Uses for Meglitinides (secretagogue)
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Stimulate release of insulin from pancreatic beta cells in the presence of glucose
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Side Effects for Meglitinides (secretagogue)
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Hypoglycemia and weight gain
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Nursing Considerations Meglitinides (secretagogue)
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Administer 1-30 mins before a meal- short duration of action
Interacts with beta blockers |
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Common Meglitinides (secretagogue)
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Nateglinide (Starlix)
Repaglinide (Prandin) |
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Uses for Thiazolidineiones (TZD)
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Increase tissue sensitivity to insulin, decrease glucose production in liver
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Side Effects with Thiazolidineiones (TZD)
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Mild weight gain, edema, not susceptible to hypoglycemia unless on other hypo meds
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Nursing Considerations for Thiazolidineiones (TZD)
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Usually add on therapy, gradual effectiveness 4-6 wks, + effects triglycerides, HDL, &LDL, May induce resumption in ovulation, observe for CHF, increase incidence of bladder cancer, black box warning again use in heart failure
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Common Thiazolidineiones (TZD)
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Pioglitazone (Actos)
Rosiglitazone (Avandia)-limited availability |
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Uses for DDP4 Inhibitors
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Stimulates pancreas beta cells to secrete more insulin in presence of glucose, decrease glucose production and metabolism of insulin in liver
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Side Effects for DDP4 Inhibitors
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Nausea, vomiting, diarrhea
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Nursing Considerations for DDP4 Inhibitors
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DDP4 enzyme cause breakdown of incretins,
Prolong life of active GLP-1 and GIP which prolongs effects of incretins hormones in reducing hyperglycemia Contraindicated by renal impairment, lower dose needed. Advantage: doesn’t usually cause hypoglycemia, thought to regenerate beta cells |
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Common DDP4 Inhibitors
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Sitagliptin (Januvia)
Saxagliptin (Onglyza) Linagliptin (Tradjenta) |
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Uses for Alpha-glucosidase inhibitors
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Inhibits enzymes in the small intestine that metabolize complex carbohydrates, Delays absorption of CHO from GI Tract, Which lowers post prandial blood sugar
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Side Effects for Alpha-glucosidase inhibitors
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Flatulence, diarrhea, nausea, vomiting
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Nursing Considerations for Alpha-glucosidase inhibitors
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Doesn’t cause hypoglycemia, may cause mild weight loss. Contraindiacated impaired hepatic function or absorption disorders, administer 1st bite
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Common Alpha-glucosidase inhibitors
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Acarbose (Precose)
Miglitol (Glyset) |
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Uses for Incretin Mimetic
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Add in DM type 2 not well controlled by oral agents.
Synthetic GLP-1 hormone Used with metformin or sulfonylureas |
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Side effects for Incretin Mimetic
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Rare
Weightloss |
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Nursing Considerations for Incretin Mimetic
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Enhances insulin secretion only in hyperglycemia, insulin secretion decreases as blood glucose normalizes
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Common Incretin Mimetic
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Exenatide (Byetta)- Subq BID 5mcq-10mcq within 60 min b4 meals morn & eve
Liraglutide (Victoza)Subq once daily 6-12 u daily |
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Uses for Amylinomimetic Agent
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Analog of amylin
Add on therapy for DM type 1 or 2 with elevated post prandial blood sugars. Patients with insulin and amylin deficiency |
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Nursing Considerations for Amylinomimetic Agent
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Amylin- protein secreted from pancreatic beta cells with insulin in response to food intake.
Do NOT use with poor compliance or with HgbA1c greater than 9. Do not mix with insulin in same syringe. Administer in separate sites at least 2 inches apart |
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Common Amylinomimetic Agent
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Pramlintide (Symlin)
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