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77 Cards in this Set
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- 3rd side (hint)
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Biguanide-first line drug |
Metformin |
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Metformin indication: |
-hyperglycemia -decreases intestinal absorption of glucose, does not cause hypoglycemia |
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Metformin administration |
P.O. |
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Metformin adverse effects |
Bloating Anorexia Abdominal discomfort |
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Metformin nursing considerations |
Contradicted in renal pts Monitor BUN and creatinine Lifestyle modifications Stop 48 hours before and after use of contrast agent |
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Sulfonylureas- second line drugs |
Glipizide Glimepiride Glyburide |
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Glipizide, Glimepiride, Glyburide indication |
-hyperglycemia -can be added to Metformin if HgbA1c is >7 -can cause hypoglycemia because it does stimulate insulin release from beta cells- type 2 DB |
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Glipizide, Glimepiride, Glyburide administration |
P.O. |
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Glipizide, Glimepiride, Glyburide adverse effects |
-hypoglycemia -nausea -wt gain -GI distress |
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Glipizide, Glimepiride, Glyburide nursing considerations |
No alcohol- can cause hypoglycemic reactions |
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Incretin enhancers |
Exenatide Dulaglutide Liraglutide
Alogliptin Linagliptin Saxagliptin |
Tide or gliptin |
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Exenatide, Dulaglutide, Liraglutide indication: |
Hyperglycemia Prevents breakdown of natural incretins and increases insulin secretion which lowers blood glucose |
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Exenatide, dulaglutide, liraglutide administration |
Subc |
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Lispro & Aspart adverse effects |
Hypoglycemia |
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Lispro and aspart considerations |
Clear solution “Mealtime insulin” Client should eat within 15 min of injection |
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Short acting insulin |
Regular |
Humulin-R Novolin-R |
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Regular insulin indication |
Hyperglycemia |
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Regular insulin (Humulin-R, Novolin-R) administration Onset Peak Duration |
SQ or IV 30-60min 2-3hr 4-6hr |
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Regular insulin adverse effects |
Hypoglycemia |
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Regular insulin considerations |
Clear solution Administer 20-30 min before meals Can be given alone or mixed with other insulin |
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Intermediate acting insulin |
Isophane |
NPH, Humulin-N, Novolin-N |
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Isophane indication |
Hyperglycemia |
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Isophane administration Onset Peak Duration |
SQ 2-3 hr Peak: 6-8 hr Duration: 12-16 hr |
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Exenatide, Dulaglutide, Liraglutide adverse effects: |
Does not usually cause hypoglycemia High incidence of NVD Pancreatitis |
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Isophane adverse effects |
Hypoglycemia |
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Isophane considerations |
White cloudy solution- has protein in it Usually taken after meals |
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Very long acting insulin |
Glargine |
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Glargine indications |
Hyperglycemia Keeps blood sugar stable between meals and over night |
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Glargine administration Onset Peak Duration |
Sq Onset 2 hr Peak: none Duration 24 hr |
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Glargine adverse effects |
Hypoglycemia |
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Glargine considerations |
Used for a basal dose Maintains blood glucose regardless of meals CANNOT be mixed with other insulin’s Given at bedtime |
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Exenatide, Dulaglutide, Liraglutide considerations |
Assess for s/s of pancreatitis (persistent severe abd pain, sometimes radiating in the back may be accompanied by vomiting) at the beginning of therapy and with dose increases. If suspected, promptly discontinue incretin enhancer and see medical attention. Monitor HgbA1c prior to and during therapy Approved by FDA as alternatives to metformin in patients who have not achieved glycemic control with metformin |
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Alogliptin, Linagliptin, Saxagliptin indication |
Hyperglycemia Prevent breakdown of natural incretins and increases insulin secretion which lowers blood glucose |
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Alogliptin, Linagliptin, Saxagliptin administration |
PO |
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Alogliptin, Linagliptin, Saxagliptin adverse effects |
Does not usually cause hypoglycemia Fewer NVD adverse effects Pancreatitis |
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Alogliptin, Linagliptin, Saxagliptin considerations |
Assess for s/s of pancreatitis (persistent severe abd pain, sometimes radiating in the back may be accompanied by vomiting) at the beginning of therapy and with dose increases. If suspected, promptly discontinue incretin enhancer and see medical attention. Monitor HgbA1c prior to and during therapy Have fewer adverse effects and work well with other anti diabetic agents |
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Rapid acting insulin |
Lispro Aspart |
Humalog Novolog |
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Lispro & aspart indication |
Hyperglycemia Lowers BS as it rises after meals |
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Lispro & Aspart administration Onset: Peak: Duration: |
SQ 15 min or less 40-60 min Duration 3-5 hr |
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Insulin combination Onset: Peak: Duration: |
Onset:15-60 min Peak: 2 peaks (one from each type) Duration: 12-16 hr |
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Antiemetics |
Promethazine Prochlorperazine |
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Promethazine & prochlorperazine indication |
-vertigo -nausea -vomiting -sedation |
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Promethazine & prochlorperazine administration |
Po IV PR |
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Promethazine & prochlorperazine adverse effects |
Drowsiness, dizziness, constipation, urinary retention, dry mouth |
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Promethazine & prochlorperazine considerations |
If used for motion sickness take 1/2 hour before traveling Avoid activities that require alertness Avoid alcohol/CNS depressants |
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Antiemetics |
Promethazine Prochlorperazine |
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Diphenhydramine, fexofenadine, loratidine, chlorpheniramine indications |
Tx allergic rhinitis, allergies, vertigo, cough, sneezing (decreases pressure) |
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Diphenhydramine, fexofenadine, loratidine, chlorpheniramine administration |
PO |
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Diphenhydramine, fexofenadine, loratidine, chlorpheniramine adverse effects |
Drowsiness, excitement, photosensitivity Anticholergenic effects: urinary retention, dry mouth, constipation |
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Promethazine & prochlorperazine indication |
-vertigo -nausea -vomiting -sedation |
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Promethazine & prochlorperazine administration |
Po IV PR |
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Promethazine & prochlorperazine adverse effects |
Drowsiness, dizziness, constipation, urinary retention, dry mouth |
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Promethazine & prochlorperazine considerations |
If used for motion sickness take 1/2 hour before traveling Avoid activities that require alertness Avoid alcohol/CNS depressants |
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Anti-vertigo antihistamines |
Meclizine Diphenhydramine. Fexofenadine. Loratidine. Chlorpheniramine. |
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Meclizine indications |
Vertigo |
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Meclizine administration |
PO |
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Meclizine adverse effects |
HA Vomiting Dry mouth Tiredness/drowsiness |
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Meclizine considerations |
Avoid activities that require alertness |
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Beta blockers (for glaucoma) |
Timolol maleate, levobunolol |
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Beta blockers (for glaucoma) |
Timolol maleate, levobunolol |
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Timolol maleate, levobunolol indication |
Decrease production of aqueous humor and reduce IOP in management of glaucoma Beta blocker |
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Beta blockers (for glaucoma) |
Timolol maleate, levobunolol |
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Timolol maleate, levobunolol indication |
Decrease production of aqueous humor and reduce IOP in management of glaucoma Beta blocker |
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Timolol maleate, levobunolol administration |
Optic- eye |
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Beta blockers (for glaucoma) |
Timolol maleate, levobunolol |
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Timolol maleate, levobunolol indication |
Decrease production of aqueous humor and reduce IOP in management of glaucoma Beta blocker |
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Timolol maleate, levobunolol administration |
Optic- eye |
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Timolol maleate, levobunolol adverse effects |
Eye irritation Hypotension Increased airway resistance |
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Timolol maleate, levobunolol considerations |
Monitor BP/P Apply light pressure to lacrimal sac for 1 min following administration Used in caution with clients already taking BB for HTN Contraindicated in clients with hx of asthma |
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Prostaglandins “Prost” first line therapy |
Travoprost Latanoprost |
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Prostaglandins “Prost” first line therapy |
Travoprost Latanoprost |
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Travoprost Latanoprost indication |
Increases ocular outflow through trabecular meshwork to decrease IOP, used to tx open angle glaucoma |
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Prostaglandins “Prost” first line therapy |
Travoprost Latanoprost |
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Travoprost Latanoprost indication |
Increases ocular outflow through trabecular meshwork to decrease IOP, used to tx open angle glaucoma |
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Travoprost Latanoprost administration |
Optic eye |
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Travoprost Latanoprost adverse effects |
Local eye irritation or redness Brown pigmentation of iris Lashes may grow longer |
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Travoprost Latanoprost considerations |
Administer once daily at bedtime Apply light pressure in lacrimal sac for 1 min following administration |
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