Chapter 32: Antidiabetic Drugs Test, Oral Hypoglycemic Drugs, Pharmacology for Nurses
The key terms in this Pharmacology course include Antidiabetic Drugs, Oral Hypoglycemic Drugs, Nurse, Pharmacology for Nurses: Practical Applications
Which information would the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.)
Explain dietary changes are not necessary.
Instruct that it is okay to skip breakfast 1 to 2 times per week.
Advise to avoid smoking and alcohol consumption.
Take your medication only as needed.
Report symptoms of anorexia and fatigue.
Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. Skipping meals can cause low blood glucose levels and should be avoided. Patients with type 2 diabetes mellitus are managed with lifestyle changes.
The nurse is preparing a patient for a computed tomography scan using iodine contrast media. What medication would the nurse question if prescribed 1 day before the scheduled procedure?
Pioglitazone
Metformin
Acarbose
Repaglinide
The concurrent use of metformin with iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore, metformin should be discontinued the day of the test and for at least 48 hours after the patient undergoes any radiologic study that requires the use of such contrast media.
Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.)
Stimulate insulin secretion from beta cells
Inhibit breakdown of insulin by liver
Enhance action of insulin in various tissues
Increase hepatic glucose production
The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs.
Which insulin can be administered by continuous intravenous (IV) infusion?
Insulin glargine
Regular insulin
Insulin detemir
Insulin aspart
Regular insulin is the only insulin used for IV therapy.
The nurse is providing education to a patient for the prescription glipizide. The nurse explains this medication is more effective when administered at which time?
30 minutes before a meal
In the morning
At bedtime
15 minutes postprandial
Glipizide works best if given 30 minutes before meals. This allows the timing of the insulin secretion induced by the glipizide to correspond to the elevation in the blood glucose level induced by the meal.
Assuming the patient eats breakfast at 8:30 A.M., lunch at noon, and dinner at 6:00 P.M., he or she is at highest risk of hypoglycemia after an 8:00 A.M. dose of NPH insulin at what time?
2:00 P.M.
5:00 P.M.
8:00 P.M.
10:00 A.M.
Breakfast eaten at 8:30 A.M. would cover the onset of NPH insulin, and lunch will cover the 2 P.M. time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.