front 1 Sulfonylureas | back 1 Glucotrol (glipizide), Micronase, DiaBeta, Glynase (glyburide), Amaryl (glimepiride) Action: Stimulates release of insulin from pancreatic islets; decreases glycogenolysis and gluconeogenesis; enhances cellular sensitivity to insulin Nursing Intervention:
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front 2 Meglitinides | back 2 Prandin (repaglinide), Starlix (nateglindine) Action: Stimulates a rapid and short-lived release if insulin from pancreas Nursing Intervention
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front 3 Biguanide | back 3 Glucophage, Riomet, Fortamet (metformin) Action: Decrease rate of hepatic glucose production; augments glucose uptake by tissues/muscles Nursing Intervention:
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front 4 Thiazolidinediones (TZDs) | back 4 Actos (pioglitazone), Avandia (rosiglitazone) Action: Increase glucose uptake in muscle; decrease endogenous glucose production Nursing Interventions
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front 5 Alpha Glucosidase Inhibitors | back 5 Precose (acarbose) Glyset (miglitol) Action: Delay absorption of glucose from GI tract Nursing Interventions
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front 6 Incretin Mimetics | back 6 Exenatide & Liraglutide Developed from the saliva of the Gila monster Stimulates insulin resistance Decrease glucagon secretion Increased satiety Decreased gastric emptying Increased risk for pancreatitis Increased risk for thyroid cancer |
front 7 Dipeptidyl Peptidase-4 (DDP-4) Inhibitors | back 7 Januvia (sitagliptin), Action: Enhances the incretin system, stimulates release of insulin from pancreatic B cells and decreases hepatic glucose production Nursing Intervention:
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front 8 Amylin Analog | back 8 Pramlintide: amylin is a hormone that is released into the bloodstream by the beta cells of the pancreas along with insulin, after a meal. Like insulin, amylin is deficient in individuals with Type 1 diabetes. It slows down the movement of food through the stomach. Researchers developed the drug from rat amylin Pramlintide is approved for use in type 1 diabetes Decreased gastric emptying Decreased glucagon secretion Decreased hepatic glucose output Increased satieity Side effects:
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front 9 Sodium-Glucose Co-Transport Inhibitors | back 9 Lower blood glucose levels by preventing kidney reabsorption of the glucose that was filtered from the blood into the urine. Glucose is excreted in the urine rather than moved back into the blood. Drugs: Canagliflozin (Invokana) and dapagliflozin (Farxiga) Hypoglycemia (hunger, headache, tremors, sweating, confusion) can occur because these drugs lower blood glucose levels even when they are not elevated Dehydration (increased thirst, lightheadedness, dry mouth, and mucous membranes, orthostatic hypotension) can occur because these drugs increase urine output and increase dehydration risk Hyponatremia (muscle weakness, decreased ability to concentrate, abdominal cramping, rapid heart rate, orthostatic hypotension) can occur because these drugs increase sodium excretion Urinary Tract Infection (frequency, pain and burning on urination, foul urine odor) can occur because the increased glucose in the urinary tract predisposes to infection GENITAL ITCHING AND VAGINAL DISCHARGE CAN OOCUR BECAUSE THESE DRUGS INCREASE THE RISK FOR GENITAL YEAST INFECTION |
front 10 Rapid Acting Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra) | back 10 Starts to work in: 15-30 minutes Peak Action: 1-2 hours Duration of Action: 3-6 hours Maximum Duration: 4-6 hours |
front 11 Short Acting Regular | back 11 Starts to work in: 30 min - 1 hour Peak Action: 2-4 Hours Duration of Action: 3-6 hours Maximum Duration: 6-8 hours |
front 12 Intermediate-Acting NPH | back 12 Starts to work in: 2-4 hours Peak Action: 8-10 hours Duration of Action: 10-18 hours Maximum Duration: 14-20 hours |
front 13 Long Acting Glargine (Lantus) and Detemir (Levemir) | back 13 Starts to work in: 1-2 hours Peak Action: NONE Duration of Action: 19-24 & 19-20 hours Maximum Duration: 24 & 20 hours |