Diabetes Drug Chart
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1
2Diabetes Drug Chart
Drug
Action
Use
Side Effects
Nursing Implications
-teach proper monitoring and
-stimulates glucose uptake by fat
-used for Type 1 diabetes
-metabolic derangements w/
management of blood sugar levels
and muscle cells
-used for Type 2 diabetes,
inadequate therapy—
-teach S/Sx of hypo/hyperglycemia
Insulin
-promotes glycogen formation in
not controlled by diet
ketoacidosis or
-rotate injection sites
liver & muscle cells
and/or oral hypoglycemics
hypoglycemic coma
DDIs: moderate to high alcohol
-lipoatrophy at injection
Lispro-rapid acting
consumption inc. hypoglycemic action of
sites
Regular-short acting
insulin
-allergies
NPH-intermediate acting
-beta-adrenergic agents or corticosteroids
Ultralente-long acting
may antagonize actions of insulin and
mask hypoglycemic state
-not to be used w/ renal or liver impaired
-blocks K channel in the
-for Type 2 diabetics
-GI distress
Sulfonylureas
patients
membrane of pancreatic ß cells;
-dizziness, drowsiness, HA
depolarizes cell & stimulates
2nd generation:
-allergies—skin rxs
DDIs: sulfonamides, salicylates,
st
1
gen:
tolbutamide (ORINASE)
-fewer side effects
release of insulin
-hypoglycemia
phenylbutazon : hypoglycemia
nd
2
gen: glipizide
-more predictable action times &
-may also decr. hepatic glucose
-weight gain
-thiazides: hyperglycemic activity
half-lives
(GLUCOTROL)
production (glyconolysis and
-beta-adrenergic blocking agents
-fewer DDIs-bind to proteins
-disulfiram-like rx or possible
gluconeogenesis) and incr. tissue
differently
hypoglycemia w/ alcohol
responsiveness to insulin
-more expensive
Insulin Enhancers
-promotes insulin secretion by the
-for type 2 diabetics
-hypoglycemia
-patients must eat w/i 30 minutes of
pancreas
administration
Repanglinide, (PRANDIN)
-stimulates insulin secretion by
- Give 1-30 minutes before meals
-used alone or in combo
-GI: same as metformin
pancreas
- Category C: do not use during
therapy w/ Metformin or
Nateglinide
- extent of insulin release is glucose
pregnancy
(STARLIX)
Glyburide
dependent (‘smart drug’)
- Avoid in patients w/ severe liver insuff
-for type 2 diabetes
- Works more quickly than Prandin
- decr. hepatic glucose
-for treatment of type 2
GI effects—anorexia,
-Avoid in patients w/ severe liver or
-
renal dx, cardiorespiratory insufficiency,
production
diabetes, alone or w/ a
flatulence, metallic taste,
Biguanides
CHF
- incr. peripheral insulin
sulfonylurea
N/V, stomach pain, weight
sensitivity esp. in muscle tissue
-does not cause
loss
DDIs: avoid alcohol—hypoglycemic
Metformin
hypoglycemia-an
- Weight loss
cimetidine, digoxin, morphine, rantidine,
(GLUCOPHAGE)
trimethorprim, furosemide,
antihyperglycemic drug
- Decr. absorption of
vancomycin—incr. blood concentration
vitamin B12 and folic acid
of metformin
-used as mono or combo therapy w/
-prolongs digestion of CHO
-for treatment of type 2
-GI: flatulence, abdominal
Alpha-glucosidase
sulfonylureas
-decr. peak plasma glucose levels
diabetes
pain, distenion, diarrhea,
-TID w/ first bite of food
inhibitors
by inhibiting intestinal enzymes
borborygmi
-SE diminish w/ time—usually 3 wks
in SI that break complex
aka “starch-blockers”
-Incr. in liver enzymes
acarabose (PRECOSE)
carbohydrates into smaller
DDIs: corticosteroids & thiazides—
miglitol (GLYSET)
molecules
interfere w/ control of hyperglycemia
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