SODIUM–GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITORS

SGLT2 inhibitors act by:

Blocking glucose reabsorption in the kidney

Prototype SGLT2 inhibitor:

Canagliflozin

Canagliflozin is administered:

Once daily before first meal

A common adverse effect is:

Genital mycotic infections

SGLT2 inhibitors should NOT be used in:

Severe renal impairment

Elderly patients are at higher risk for:

Syncope and dehydration

SGLT2 inhibitors cause:

Increased urinary glucose excretion

In pregnancy, SGLT2 inhibitors are:

Contraindicated

Which electrolyte abnormality is possible?:

Hyperkalemia

Foot care is critical due to risk of:

Amputations

Canagliflozin increases risk of:

Bone fractures

Volume depletion may cause:

Hypotension

Canagliflozin should be started:

Low dose with hydration

Black Box warning includes:

Increased amputation risk

Metabolic side effects include:

Increased LDL

A patient reports perineal pain, suspect:

Necrotizing fasciitis

Excretion of canagliflozin:

Urine + feces

Avoid combining with:

Potassium-sparing diuretics

Initial patient education includes:

Hydrate well

If a patient reports dizziness:

Check hydration + BP

Which drugs can reduce canagliflozin levels?:

Carbamazepine

SGLT2 inhibitors may:

Slow kidney disease progression

Monitoring labs include:

Potassium

Counseling for genital infection risk includes:

Hygiene + notify for symptoms

Common side effect in women:

Vulvovaginal candidiasis

Serious renal adverse effect:

Acute kidney injury

Canagliflozin’s half-life with 300 mg dose:

13.1 hrs

Monitoring for bone health is needed due to:

Fracture risk

The nurse teaches patients to:

Avoid salt substitutes

Drug interaction with St. John’s Wort:

↓ SGLT2 levels → hyperglycemia

Dosing for canagliflozin with eGFR 45–59:

Max 100 mg/day

A sign to report urgently:

Severe leg pain

SGLT2 inhibitors:

Should not be used in Type 1 DM

A nurse should assess for:

Syncope

Teaching for SGLT2 inhibitors:

Maintain 2–3 L/day fluids