Pharmacology - Chapter 32 - Antibiabetic Drugs

Question 0

What are the signs and symptoms of hypoglycemia?

Answer 0

Shaky, 
fast heartbeat, 
sweating, 
dizziness, 
anxiety, 
hunger, 
blurry vision, 
weakness or fatigue, 
headache, 
irritability

Question 1

What are the signs and symptoms of hyperglycemia?

Answer 1

Extreme thirst, 
need to urinate frequently, 
dry skin, 
hunger, 
blurry vision, 
drowsiness, 
slow healing wounds

Question 2

How long is onset for rapid acting insulin?

Answer 2

5 to 15 minutes

These have a shorter duration and patients must eat a meal after injection

Question 3

Which insulin drugs are rapid acting?

Answer 3

Humalog (lispro),
NovoLog (aspart),
Apidra (glulisine)

Maybe given subcutaneously or via continuous subcutaneous infusion pump but not by IV

Question 4

How long is onset for short acting (regular) insulin?

Answer 4

30 to 60 minutes

This is the only insulin product that can be given by IV bolus, IV infusion, or intramuscularly

Question 5

Which insulin drugs are short acting (regular)?

Answer 5

Humulin R

Question 6

Which insulin drugs are intermediate acting?

Answer 6

Isophane isuline suspension (NPH)

Has cloudy appearance

Question 7

Which insulin drugs are long acting?

Answer 7

Lantus (glargine),
Levemir (determir)

Clear, colorless solution,
Referred to as basal insulin

Question 8

_____ insulin doses adjust according to blood glucose test results

Answer 8

Short acting/regular

Also called sliding scale insulin dosing.
Typically used in hospitalized diabetic patients or those on TPN or enteral tube feedings

Question 9

What is the disadvantage of sliding scale insulin dosing?

Answer 9

Delays insulin administration until hyperglycemia occurs;

Results in a large swings and glucose control

Question 10

This classification of oral antidiabetic drugs is considered to be a first-line drug, especially for patients with a body mass index over 25

Answer 10

Biguanide

Decreases glucose production by the liver, they also increase intestinal absorption of glucose and improve insulin receptor sensitivity. Does not stimulate insulin secretion or weight gain

Question 11

Which oral medications are biguanides?

Answer 11

Metformin (glucophage)

Question 12

Evers effects of Biguanides?

Answer 12

Abdominal bloating, 
nausea, 
cramping, 
diarrhea, 
metallic taste in mouth, 
reduced vitamin B 12, 
lactic acidosis (lethal)

Does not cause hypoglycemia

Question 13

This classification of oral anti diabetic drugs bind to receptors on beta cells to stimulate the release of insulin. They also decrease the secretion of glucagon. These work best during early stages of type 2 diabetes

Answer 13

Sulfonylureas

Question 14

Which oral medications are Sulfonylureas?

Answer 14

First generation:
Diabinese (chloropropamide),
Tolinase (tolazamide)

Second generation:
Amaryl (glimepiride,
Glucotrol (glipizide),
DiaBeta, Micronase (glyburide)

Question 15

What are the adverse effects of Sulfonylureas ?

Answer 15

Hypoglycemia, 
weight gain, 
skin rash, 
nausea, 
heartburn

Question 16

This classification of antidiabetic drugs increases insulin secretion from the pancreas. They bind to receptors on beta cells to stimulate the release of insulin. They have a shorter duration of action and must be given with each meal.

Answer 16

Glinides

Question 17

Which oral anti diabetic drugs are Glinides ?

Answer 17

Prandin (repaglinide),

Starlix (nateglinide)

Question 18

What are the adverse effects of Glinides?

Answer 18

Headache, 
hypoglycemic affects, 
dizziness, 
weight gain, 
joint pain, 
upper respiratory infection or flu like symptoms

Question 19

These oral antidiabetic drugs decrease insulin resistance, increase glucose uptake and use in skeletal muscle, inhibit glucose and triglyceride production in the liver. They are “insulin sensitizing drugs”.

Answer 19

Thiazolidinediones

Question 20

Which oral antibiotic drugs are Thiazolidinediones (aka Glitazones)?

Answer 20

Actos (pioglitazone),

Avandia (rosiglitazone),

Question 21

What are the adverse effects of Thiazolidinediones (Glitazones)?

Answer 21

Moderate weight gain,
edema,
mild anemia,
hepatic toxicity

Question 22

These oral antidiabetic drugs reversibly inhibit the enzyme alpha-glucosidase in the small intestine, resulting in delayed absorption of glucose. They must be taken with meals to prevent excessive postprandial blood glucose elevation

Answer 22

Alpha-glucosidase inhibitors

Question 23

Which anti-diuretic drugs are classified as Alpha-glucosidase inhibitors?

Answer 23

Precose (acarbose),

Glyset (miglitol)

Question 24

What are the adverse affects of Alpha-glucosidase inhibitors?

Answer 24

Flatulence,
diarrhea,
abdominal pain

These do not cause hypoglycemia, hyperinsulinemia, or weight gain
They are given with the first bite of each main meal

Question 25

These oral antidiabetic drugs mimic the natural hormone amylin. They slow gastric emptying, suppress glucagon secretion, reducing hepatic glucose output. They centrally modulate appetite and are used when other drugs have not achieved adequate glucose control.

Answer 25

Amylin mimetics

Question 26

Which oral Antidiuretic drugs are amylin mimetics?

Answer 26

Symlin (pramlintide)

Question 27

What are the adverse effects of amylin mimetics?

Answer 27

Nausea, vomiting, anorexia, headache

Question 28

These oral antidiabetic drugs stimulate insulin secretion, reduce postprandial glucogon production, slow gastric emptying, and increase satiety

Answer 28

Incretin mimetics

Question 29

Which anti diabetic drugs are in the category incretin mimetics?

Answer 29

Byetta (exenatide),

Januvia (sitagliptin)

Question 30

What are the adverse affects of incretin mimetics?

Answer 30

Nausea,
vomiting,
diarrhea,
weight loss

Should be taken one hour before other medication

Question 31

What are early signs of hypoglycemia?

Answer 31

Confusion,
irritability,
tremors,
sweating

Question 32

Oral glucose elevating drugs come in these forms?

Answer 32

Buccal tablets,

Semisolid gel

Question 33

Nursing implications to consider before giving drugs that alter glucose levels?

Answer 33

Vital signs, 
blood glucose level, 
A-1 C level, 
potential complications,
drug interactions

Question 34

What are the medications/substances that affect hypoglycemic glucose levels?

Answer 34

Acetaminophen, 
alcohol, 
beta blockers, 
NSAIDs, 
Alipurinol, 
tricyclic antidepressants

Question 35

What are the medications/substances that affect hyperglycemic glucose levels?

Answer 35

Large doses of caffeine, 
calcitonin, 
calcium channel blocker's, 
morphine, 
corticosteroids, 
furosemide (Lasix), 
oral contraceptives, 
barbiturates