therapeutic effect/ administration
which drug is first line in therapy and what class is the drug in
metformin: class is biguanide
MOA for metformin
1. inhibits glucose production in liver
2. increase insulin sensitivity in target tissues
3. lowers blood glucose (does not cause hypoglycemia)
adverse effects for SGLT-2
dehydration
UTI, fungal infection, genital necrotizing infections
postural hypotension
what is a main interaction for sulfonylureas
Beta blockers, mask shakiness of hypoglycemia
what should women do when taking TZDs
take calcium and practice weight bearing exercises
which drug is shown to prevent CV events
SGLT-2 inhibitors
MOA for DPP-4
- stimulates insulin release from pancreas
- suppress postprandial release of glucagon
Adverse effects for GLP-1
GI effects- N/V/D and reflux
what drugs increase risk of hypoglycemia in DPP-4
insulin and sulfonylureas
what should the nurse tell a patient about when and how to take acarbose
3 x daily at the start of each meal
how is GLP-1 receptor agonists administered
subs (prefilled pens) and some oral
MOA for acarbose
delays absorption of carbohydrates
2 Main adverse effect of metformin that are different from other drugs
what drugs decrease the effect of SGLT-2
rifampin, phenytoin, and phenobarbital
what should a patient report when taking DPP-4
s/sx of pancreatitis
when and how many times do you take SGLT-2
in the morning once a day
what is TZDs metabolized by
CYP enzyme
Main adverse effect for DPP-4
Hypersensitivity reactions (anaphylaxis, SJJ, angioedema)
what do you need to avoid when taking metformin
alcohol
what should a nurse teach a patient taking SGLT-2
hydrate and practice good hygiene
how do you administer metformin
PO and with meal
MOA for GLP-1 receptor agonists
- mimics incretin hormone
- stimulates release of insulin
-suppresses postprandial release of glucagon
- slows gastric emptying
- suppresses appetite
Adverse effects of TZDS
bladder cancer, fractures in women, hepatotoxic, and fluid retention
who should you take caution in when prescribing metformin
impaired renal function, alcoholics, history of liver disease/failure
what should a nurse teach a patient taking metformin
take b12 and folate supplements, and take with large meal, no alcohol