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    Sulfonylurea Agents (Diabinese, Glucotrol, Diabeta) : 2. Meglitinide Analogues (Prandin)

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    Kristin Edwards
    This document discusses different types of oral medications and insulin therapies used to treat hyperglycemia. It describes several classes of oral medications including sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors, and thiazolinediones. It also discusses the injectable drug Exenatide and various types of insulin therapy including basal, bolus, and correction insulin. Different insulin categories like short-acting, intermediate-acting, and long-acting insulins are also summarized.

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    Sulfonylurea Agents (Diabinese, Glucotrol, Diabeta) : 2. Meglitinide Analogues (Prandin)

    Uploaded by

    Kristin Edwards
    40 views11 pages
    This document discusses different types of oral medications and insulin therapies used to treat hyperglycemia. It describes several classes of oral medications including sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors, and thiazolinediones. It also discusses the injectable drug Exenatide and various types of insulin therapy including basal, bolus, and correction insulin. Different insulin categories like short-acting, intermediate-acting, and long-acting insulins are also summarized.

    Original Description:

    Diabetes meds

    Original Title

    Diabetes Medications

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    This document discusses different types of oral medications and insulin therapies used to treat hyperglycemia. It describes several classes of oral medications including sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors, and thiazolinediones. It also discusses the injectable drug Exenatide and various types of insulin therapy including basal, bolus, and correction insulin. Different insulin categories like short-acting, intermediate-acting, and long-acting insulins are also summarized.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    40 views11 pages

    Sulfonylurea Agents (Diabinese, Glucotrol, Diabeta) : 2. Meglitinide Analogues (Prandin)

    Uploaded by

    Kristin Edwards
    This document discusses different types of oral medications and insulin therapies used to treat hyperglycemia. It describes several classes of oral medications including sulfonylureas, meglitinides, biguanides, alpha-glucosidase inhibitors, and thiazolinediones. It also discusses the injectable drug Exenatide and various types of insulin therapy including basal, bolus, and correction insulin. Different insulin categories like short-acting, intermediate-acting, and long-acting insulins are also summarized.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 11

    Risk for Injury Related to

    Hyperglycemia: RX
    Medications – Oral
    1.
    Therapy
    Sulfonylurea agents (Diabinese,
    Glucotrol, DiaBeta)
    – Stimulate insulin secretion
    – ↓ WBC, ↓platelets, hemolytic anemic, allergic, GI
    – Long duration
    – Many drug interactions
    2. Meglitinide analogues (Prandin)
    – Stimulate insulin secretion
    – ↓ WBC, ↓ platelets, hemolytic anemic, allergic, GI
    – Rapid onset, limited duration

    LAD USC Upstate


    3. Biguanides (Metformin
    = Glucophage)
    –↓ liver glucose release, ↓ cellular
    insulin resistance, facilitates action
    of insulin on receptor sites
    – Hold before IV contrast and
    anesthesia
    – Can cause lactic acidosis

    LAD USC Upstate


    Oral therapy (Type II)
    (cont)
    4. Alpha-glucosidase inhibitors
    (Precose)
    – Slow GI digestion and absorption of CHO
    – Take with first bite of meal
    – SE: flatulence, diarrhea
    • 5. Thiazolinedione antidiabetic agents
    (Actos, Avandia, Rezulin)
    – Enhance sensitivity to insulin, ↑ insulin action
    and glucose utilization in peripheral tissues
    – Potential for liver damage

    LAD USC Upstate


    Adjunct to Oral Agents
    Exenatide = Byetta
    – Improves glycemic control in Type II DM by
    enhancing beta-cell secretion of Insulin in the
    presence of elevated glucose levels;
    suppresses inappropriate glucagon secretion;
    slows gastric emptying
    – Is added to metformin, or a sulfonylurea in
    patients with Type II DM who have not
    achieved adequate glycemic control
    – Is injected SC BID, ~ 60 minutes before
    eating; keep refrigerated; use w/n 30 days
    – SE: hypoglycemia, HA, dizziness, ↓ appetite,
    nausea; ↓ absorption of other meds

    LAD USC Upstate


    INSULIN Therapy – trying to
    duplicate normal body
    production of Insulin
    • Basal coverage with NPH or Lente or
    Lantus (N)
    • Bolus = Meal =Prandial or immediate needs
    with Regular (R ) or immediate, quick acting
    Humalog
    • Correction insulin = sliding scale – for a
    specific blood sugar level with Regular or
    Humalog
    • Categories (See Handout)
    – Short-acting insulin
    – Intermediate acting
    – Long acting
    LAD USC Upstate
    Insulin Therapy (Continued)
    – Fixed-combination (70/30, 50/50)
    – Concentrated insulins for pumps
    – Nurses should never hold a patient’s insulin
    without an MD order. As the patient’s
    advocate if you have concerns regarding an
    insulin dose, call the MD. Holding insulin or
    changing the dose of insulin without an MD
    order is prescribing and is outside the scope
    of an RN’s licensure.

    LAD USC Upstate


    Ordering of Insulin

    • BASALTo control endogenous


    glucose production Long acting insulin
    – Replacement:
    • Regular insulin infusion (IV pump)
    • NPH 2-3 injections daily
    • Insulin pump
    • Glargine injected daily
    • Detemir injected 1-2 times per day
    – You always need basal insulin
    LAD USC Upstate
    BOLUS= Meal To cover food intake
    Immediate acting or short acting insulin

    – Replacement:
    • Regular Insulin SC- injected 15-30 minutes before meal.
    • Analogue SC( Aspart- Novolog or Lispro- Humalog)- injected
    within 10 minutes of meal
    • Bolus function for patients on an insulin pump

    Should always be given before or with a meal. Analogue may be


    given after the meal if the patient’s intake is questionable, so that
    the dose can be based upon amount of food consumed.
    LAD USC Upstate
    • Unscheduled meals or snacks without insulin
    will lead to unexpected hyperglycemia and if
    not known about may result in inappropriate
    changes in the basal insulin, putting the client
    at risk for future hypoglycemia.
    • Therefore, do not give unscheduled snacks
    that are not included in the client’s prescribed
    diet; teach your client to report any food
    brought in by family/friends.

    LAD USC Upstate


    Insulin Profiles
    Aspart, Lispro, Glulisine

    Regular
    Plasma Insulin Levels

    NPH

    Glargine
    Detemi
    r

    0 2 4 6 8 10 12 14 16 18 20 22 24
    Time (hr)
    Rosenstock J. Clin Cornerstone.
    LAD2001;4:50
    USC Upstate J. Whitside SRHS 10/07
    What’s in a Name?? Insulin
    • NOVOLOG is the same as ASPART

    • LANTUS is the same as GLARGINE

    • LEVEMIR is the same as DETERMIR

    NOVOLIN / HUMULIN are not names of insulin,


    These are brands.
    Be sure to include which kind of Novolin / Humulin insulin
    you are describing/administering.

    LAD USC Upstate

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