Nursing T2DM Drugs

what class of drugs are Glipizide’s 

sulfonylureas

where do glipizide’s work

In the pancreas

What is glipizide’s mechanism of action

stimulate the pancreas to release insulin

How do you take glipizide’s

30 min before eating, don’t crush the sustained release pill

What are the most common risks with taking glipizide’s 

Hypoglycemia 

What are the most dangerous risks taking Glipizide’s

sever hypoglycemia especially with alcohol

who should NOT take glipizide’s

T1DM, pregnant, DKA, sever hepatic (liver) or kidney (renal) disease

what class of drug is repaglinide 

meglitinides 

where does repaglinide work

in the pancreas

what is the mechanism of action of repaglinides

rapid, short acting insulin release

how do you take repaglinide

30 min before meals, skip the dose if you skip a meal, max 4x/day

what are the most common risks of repaglinides

hypoglycemia, sever hypoglycemia especially with gemfibrozil

what is gemfibrozil 

cholesterol medication 

what should gemfibrozil be watched for when mixed with repaglinide

sever hypoglycemia

what two medications when mixed can cause severe hypoglycemia

gemfibrozil and repaglinide

what class of drug is metformin

biguanide 

where does metformin work 

in the liver, intestine, tissue 

what is the mechanism of action for metformin

lowers glucose absorption in intestine, lowers glucose production in liver, increases insulin sensitivity

how do you take metformin

with meals, ER (extended release) with evening meal

what is the most common risk of metformin

Gi upset, diarrhea, nausea, metallic taste

what is the most dangerous risk of metformin

lactic acidosis

when should you not use metformin

renal failure, liver failure, heart failure, COPD, alcoholism

what should you do if contrast dye is required for scans while patient is taking metformin

hold metformin for 48 hours before contrast dye, and 48 hours after contrast dye (check renal function)

what class of drug is pioglitazone/rosiglitazone

TZDs, glitazone

where do rosiglitazone’s and pioglitazone’s work

muscle, fat cells

what is the mechanism of action for pioglitazone, rosiglitazone

increases insulin sensitivity, decreases insulin resistance

how do you take pioglitazone and rosiglitazone

1x/day

what is the most common risk of pioglitazone and rosiglitazone

edema (liquid resistance), weight gain

what is the most dangerous risk of pioglitazone and rosiglitazone 

heart failure, liver injury, bladder cancer

when should you not use pioglitazone and rosiglitazone

any heart failure, liver disease, bladder cancer history, T1DM

what class of drug is acarbose

alpha-glucosidase inhibitor

where does acarbose work

small intestine

how does acarbose work

blocks carb breakdown, lowers post-meal glucose release

how do you take acarbose

with the FIRST bite of food

what are the most common risks of acarbose

severe Gi gas, bloating, diarrhea

what are the most dangerous risks of acarbose

liver injury (long term use), iron deficiency anemia

how do you treat someone who is taking acarbose and is hypoglycemic

only with glucose tablets

who should not take acarbose 

bowel obstruction, IBD (inflammatory bowl disease), Gi ulcers 

what class of drug is sitagliptin in

DPP-4 inhibitor, gliptin

where does sitagliptin work 

incretin hormone system 

how does sitagliptin work

blocks the DPP-4 enzyme, increases incretin, which increases insulin, and decreases glucagon

what are the most common risks of sitagliptin

URI (upper respiratory infections, headache

what are the most dangerous risks of sitagliptin

pancreatitis, SJS, angioedema (swelling under the skin)

who should not use sitagliptin

T1DM, DKA, sever renal failure

how do you take sitagliptin

1x/day, adjust dose with renal failure