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34 Cards in this Set

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Which oral antidiabetics do NOT cause hypoglycemia as an adverse effect?(3)
Biguanide (metformin/Glucophage); Alpha-glucosidase inhibitors (acarbose/Precose); and Glitazones (Thiazolidinediones) which are pioglitazone (Actos) and rosiglitazone (Avandia).
1. Cheapest oral antidiabetic.
2. Mechanism of action of sulfonylureas.
1. Sulfonylureas
2. Stimulate the pancreas - increased production of insulin and increased use of glucose; may help increase the sensitivity of insulin receptors.
1. sulfonylureas are ____-based drugs.

2. As a side effect sulfonylureas can cause (3)

3. Pt. teaching for sulfonylureas

4. drug interactions with sulfonylureas
1. sulfa

2. hypoglycemia, wt. gain, photosensitivity

3. Administer with meals; keep on the same time each day.

4. highly protein bound; interact with NSAIDS, Symetidine, GI meds.
1. The only Biguanide available in the US is __.

2. Biguanides may be used for __or__.

3. Mechanism of action of Biguanides (3)
1. Glucophage (Metformin).

2. Type I and II diabetes.

3. Decrease gluconeogenesis (production of glucose);
increase uptake/use of glucose. (lessening of insulin resistance); decrease intestinal absorption.
1. Biguanides are the only oral antidiabetic to __.

2. Adverse effects of biguanides. (2)

3. Pt. teaching for biguanides
1. promote weight loss

2. GI upset; heartburn

3. Take with food to decrease gi upset.
1. The only alpha-glucosidase inhibitor available in the US

2. Alpha-glucosidase inhibitors work for ____ only.

3. Mechanism of action of Precose

4. Adverse effects and contraindications of Precose
1. acarbose (Precose).

2. Type II diabetes.

3. Inhibits digestive enzyme of small intestine. Slows absorption of carbohydrates, decreasing postprandial (after meal) blood sugar.

4. Flatulence/bloating r/t undigested carbs; contraindicated for patients with ulcerative colitis or IBS.
1. prototype for Glitazones

2. developed _____.

3. Mechanism of action of glitazones

4. Side effects of glitazones

5. glitazones require ___ to be effective so for ___ only.
1. Avandia

2. late 90's..newer drug.

3. Decrease insulin resistance; gets to target cells and gets them to respond to insulin. (insulin sensitizers)

4. Edema and fluid retention/wt gain.

5. insulin; type II
1. Newer oral antidiabetic similar in action to sulfonylureas but faster, more rapid onset.

2. Prandin is for ____ diabetes only

3. Mechanism of action of Prandin (meglitinides)

4. Meglitinides are to be taken ____.

5. Biggest side effect of meglitinides (Prandin) is ___which we would look for when?
1. Meglitinides (Prandin)

2. Type II

3. Stimulates secretion of insulin from pancreas

4. postprandial

5. hypoglycemia
1 hour
1. If a patient on Meglitinides (Prandin) skips a meal, they should ___.
1. skip their pill; don't take double dose.
Which oral anti diabetics cause weight gain? (2)
Sulfonylureas (Diabeta)
Glitazones (Avandia)
Which oral antidiabetics cause weight loss?
Biguanides (Glucophage)
Which oral antidiabetics cause hypoglycemia?
Sulfonylureas (Diabeta); peaks in 1 1/2 to 3 hours.
Meglitinides (Prandin); peaks in 1 hour
1. Prototype drug for histamine 2 receptor antagonists (H2 Blockers)

2. Indications for Tagamet
1. Tagamet (cimetidine)

2. PUD; indigestion
1. How is Tagamet given?

2. Tagamet (cimetidine) has a ___ 1/2 life, lasts ___ and can __ __.

3. Mechanism of action of Tagamet (cimetidine - H2 blocker)
1. Oral, IV or IM

2. short, 4-5 hours, crosses placenta

3. Blocks histamine 2 receptors which decreases gastric acid secretions.
1. Adverse effects of Tagamet (cimetidine - H2 Blocker)
1. Cardiac arrest
CNS (h/a; dizziness)
GI (diarrhea)
impotence
1. Pt. teaching for Tagamet
1. Inform pt. that smoking interferes with the actionof histamine antagonists. Encouage patient to quit smoking or at least not to smoke after last dose of the day. May cause drowsiness/dizziness. Alcohol, aspiring, NSAIDs may increase in GI irritation. Advise pt. to report onset of black, tarry stools; fever; sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to healthe care prof.
1. Zantac (ranitidine) is a ________.

2. Zantac can be given :

3. Zantac's mechanism of action:
1. H2 Blocker

2. oral, IM, or IV

3. Inhibits histamine at H2 receptor site in parietal cells, which inhibits gastric acid secretion
1. Adverse effects of Zantac

2. Drug interactions c Zantac

3. Nursing considerations c Zantac
1. h/a, malaise, dizziness and somnolence; hepatotoxicity can be life threatening.

2. Antacids will decrease absorption; anticoagulants, sulfonylureas will increase absorption.

3. Watch for GI complaints (n/v/d, cramps)
1. Prototype drug for proton pump inhibitors.

2. Indications for omeperazole (Prilosec)
1. Prilosec (omeperazole)

2. GERD, active duodenal ulcers with or without antinfectives for H. Pylori, systemic mastocytosis
1. Mechanism of action of proton pump inhibitor Prilosec.
1. Suppresses gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in gastric parietal cells. Blocks final step of acid production.
1. Adverse effects of Prilosec (proton pump inhibitors)
1. h/a, dizziness, chest pain, angina, tachycardia, bradycardia, palpitations, tinnitus, taste perversion, gi upset, uti, hypoglycemia, thrombocytopenia.
1. Nursing considerations with Prilosec (proton pump inhibitors)
1. Do not take before eating. Hypoglycemia in diabetics. Avoid alcohol and Iuprofin (GI irritation); Check bowel sounds, hepatic enzymes. Severe diarrhea...discontinue.
1. The only proton pump inhibitor that can be given IV is...
1. Protonix (pantoprazole)
1. How would renal disease effect dosing of H2 Blockers?

2. Caution used with H2 Blockers with which pts?

3. When should Prilosec (proton pump inhibitors) be taken?
1. Doses should be lowered.

2. renal and liver pts.

3. 30 minutes before meals (food affects absorption)
1. Drug interactions with pantoprazole (Protonix) proton pump inhibitor.

2. Protonix (proton pump inhibitors) is usually given when?

3. Protonix suppresses __ and drugs requiring that to be at a certain level will be effected.
1. With warfarin you can have increased risk of bleeding. Clarithromycin and diazepam increase Protonix levels...lower dose.

2. in the morning; before meals

3. pH
1. Prototype drug for pepsin inhibitors

2. Mechanism of action of sucralfate (Carafate) pepsin inhibitor
1. Sucralfate (Carafate)

2. Reacts with gastric acid to form a thick paste which selectively adheres to the ulcer surface.
1. sucralfate (pepsin inhibitor) is contraindicated for

2. GI med that does NOT interfere with acid and pH.

3. Nursing considerations with sucralfate
1. patients with renal impairment because of the sucrose and aluminum dioxide content.

2. Sucralfate (Carafate) pepsin inhibitor

3. Take on empty stomach. Don't crush; avoid smoking, alcohol, caffeine. Advise pt. to continue therapy if feeling better. Do not double dose. Increase fluid intake, dietary bulk and exercise to prevent constipation. Can cause dizziness, drowsiness. Take 1 hour before meals.
1. Antacids should be taken how?

2. Mechanism of action of antacids

3. Adverse effects of antacids
1. 1-3 hours postprandial, on a regular schedule; chew thoroughly.

2. Reacts with gastric acid to produce neutral salts or salts of low acidity. Goal is to raise gastric pH.

3. Constipation, diarrhea, sodium loading: can exacerbate HTN and CHF. Pt.with renal insufficiency should not take.
List seven mechanisms of action of antiinfective drugs.
1. drugs that inhibit bacterial cell wall synthesis or activate enzymes that disrupt the cell wall

2. drugs that increase cell membrane permeability

3. drugs that cause lethal inhibition of bacyerial protein synthesis

4. drugs that cause nonlethal inhibition of protein synthesis

5. drugs that inhibit bacterial synthesis of nucleic acids

6. antimetabolites

7. inhibitors of viral enzymes
1. examples of drugs that inhibit cell wall synthesis or activate enzymes that disrupt the cell wall (4)

2. examples of drugs that increase cell membrane permeability (2)
1. penicillins; cephalosporins; Imipenem; Vancomycin

2. Amphotericin B; Ketoconazole
1. example of drugs that cause lethal inhibition of bacterial protein synthesis (BACTERICIDAL)(1)

2. example of drugs that cause nonlethal inhibition of protein synthesis. (BACTERIOSTATIC)(4)
1. aminoglycosides (gentamicin)

2. Tetracyclines; Clindamycin; Erythromycin; Linezolid
1. examples of drugs that inhibit bacterial synthesis of nucleic acids (DNA and RNA)(2)

2. Antimetabolites (3)

3. Inhibitors of viral enzymes (4)
1. rifampin and the fluoroquinolones (ciprofloxacin)

2. Flucytosine; Sulfonamides; Trimethoprim

3. protease inhibitors and nucleoside analogs: Zidovudine, Acyclovir, and Saquinavir, Indinavir
1. Inhibitor of nycolic acid synthesis (1)

2. Bactericidal agents work by which 3 mechanisms of action?
1. Isoniazid

2. Inhibit/disrupt cell wall (cell explodes); increase cell membrane permeability (contents leak out) or lethal inhibition of bacterial protein synthesis.
1. Bacteriostatic agents work by which mechanisms of action?
1.