Oral Agents Type Ii Dm

Front 1

Sulfonylureas drug:

Back 1

glyburide

Front 2

1st and 2nd generation

Back 2

2nd generation lasts longer with less adverse effects

Front 3

Sulfonylureas Action:

Back 3

Increase insulin secretion from pancreas
Improves insulin sensititvity @ cells
Decreased hepatic glucose production
(gluconeogenesis)

Front 4

Sulfonylureas Adverse Effects:

Back 4

GI: weight Gain, N/V, anorexia
Hypoglycemia 3-4 hours after taking

Front 5

Sulfonylureas Precautions:

Back 5

Sulfa drugs
Impaired liver or renal function

can lead to increased chance of hypoglycemia

Front 6

Meglitinides Drugs:

Back 6

glinide (don't confuse w/ide)

Front 7

Meglitinides Action:

Back 7

Mimics normal insulin release during & just after a meal
Increases insulin secretion from pancreas
Only goes to the pancreas !!

Front 8

Meglitinides Adverse effects:

Back 8

Similar to sulfoynureas: weight gain, nausea, anoresia, hypoglycemia 3-4 hours after taking

Front 9

Meglitinides Teaching/Education:

Back 9

Mimics normal post prandial activity
Give STAT before meals because it works this fast
Skip meal=skip dose
Good for irregular eaters

Front 10

Biguanides

Back 10

metformin

Front 11

Biguanides Action:

Back 11

Decreases glucose absorption in GI tract
Increases insulin sensitivity @ cells
Decreases liver glucose production (gluconeogenesis)
* has nothing to with Insulin production
* decreases triglyceride & LDL
*promotes weight loss

Front 12

Biguanides Adverse Effects:

Back 12

N/V, discomfort, gas, wgt loss, metallic taste
Rare hypoglycemia (alone)
Lactic Acidosis

Front 13

Biguanides Precautions:

Back 13

Alcoholism
Metabolic acidosis
renal and liver impairment
* will increase risk lactic acidosis
Elderly
* decreased excretion which could increase risk for lactic acidosis

Front 14

Biguanides Teaching/edu:

Back 14

Similar to Sulfonyureas
teach to tolerate metallic taste (take w/food)

Front 15

Thiazolidinediones

Back 15

Glitazone

Front 16

Thiazolidinedione Action:

Back 16

Increase sensitivity of insulin @ cells
May take up to 3 mos to reach therapeutic levels

Front 17

Thiazolidinedione Adverse effects:

Back 17

Headache (severe)
Fluid retention
Weight gain

Front 18

Thiazolidinedione Precautions:

Back 18

heart failure (increased fluids)
Liver imprairment-HEPATIC metabolism which may lead to toxicity
Watch for fatigue, dark conc UA, N/V

Front 19

Thiazolidinedione Teach/edu

Back 19

Signs off liver impairment
Monitor liver function (ALT, AST)

Front 20

Alpha Glucosidase Inhibitor drugs:

Back 20

Precose
Glyset

Front 21

Alpha Glucosidase Inhibitor Action

Back 21

Delays disgestion & absorption of CHO in small intestine

works at source of carbs instead of at pancreas, mimics normal glucose, mimics normal body process)

Front 22

Alpha glucosidase Inhibitor Adverse:

Back 22

cramping, diarrhea, N/V, flatuence

Front 23

Alpha glucosidase Inhibitor Precautions:

Back 23

Bowel disease (IBD, Crohns, Ulcerative colitis)

Front 24

Alpha Glucosidase Inhibitors Teach/edu

Back 24

Take with FIRST bite of meal
Skip meal = skip dose
Hypoglycemic reaction=only glucose tabs work !!!!
Sugar/candy doesn't work ..will delay breakdown of table sugras (sucrose)

Front 25

Noninsulin Polypeptide Analog Drugs:

Back 25

exantide

Front 26

Noninsulin Polypeptide Analogues Teaching

Back 26

Not insulin
Take 60 min before 1st and last meal of day
prefilled pen
Keep in fridge (cooler)

Front 27

Amalyin Analogue

Back 27

Symlin

Front 28

Amylin Analogue Teaching:

Back 28

prefilled pen
not insulin
SC right before meals into abd or thigh
Never mix w/insulin
Skip meal=skip dose

Front 29

Metal taste

Back 29

Meformin

Front 30

Lactic acidosis:

Back 30

Biguanides metformin

Front 31

Rare hypoglycemia

Back 31

Biguanides metformin

Front 32

IVP dye

Back 32

Biguanides metformin

Front 33

Hepatic (liver) metabolism

Back 33

Glitazones

Front 34

heart failure precaution

Back 34

Glitazones

Front 35

S&S liver impairment

Back 35

dark conc urine, Fatigue, N/V

Front 36

Severe headache

Back 36

Glitazones

Front 37

Table sugar

Back 37

No help in hypoglycemia with precose/glyset

Front 38

Beneficial effect of decrease triglycerides, LDL and weight loss:

Back 38

Biguanides metformin

Front 39

Bowel disease

Back 39

precose.glyset

Front 40

First bite

Back 40

precose/glyset

Front 41

injectable

Back 41

analogues: exantide/Symlin

Front 42

Fridge

Back 42

exantide