NUR 112 - IGGY Med Surg I Ch 67 oral.txt

a. An oral diabetes drug that is a combination of: glyburide and metformin which have different mechanisms of action.

b. Metformin added to regimen when blood glucose is inadequately controlled on glyburide therapy alone.

c. Teach patients how to prevent and treat hypoglycemia because hypoglycemia may occur when metformin is given in combination with sulfonylurea agent.

D. Nateglinide (Starlix)

B. Metformin (Glucophage)

D. Chlorpropamide (Diabinese)

B. Miglitol (Glyset)

• a. oral diabetes drug
• b. Increase insulin secretion in the treatment of type2 diabetes; and Short-acting agent used to prevent postmeal blood glucose elevation.
• c. Usual dose 60-120 mg before meals

Teach patients to take the drug 3 times daily, 1 -30 min before meals which is most effective

• a. oral diabetes drug
• b. Improves tissue sensitivity to insulin in the treatment of type 2 diabetes.
• c. Usual dose: 15 mg or 30 mg once daily without regard to meals

Emphasize the need for liver function tests as recommended. Instruct patients to report symptoms of unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, or dark urine.

RATIONALE: Rare cases of liver failure have occurred with pioglitazone. Liver function tests are measured at the start of therapy and at regular intervals thereafter. Not recommended for moderate to severe liver impairment or in patients with jaundice.

Advise women of the need for effective contraception during therapy.

RATIONALE: Administration of pioglitazone with certain oral contraceptives may reduce the plasma concentration of the oral contraceptive. Post-menopausal women with insulin resistance may resume ovulation during therapy.

Monitor weight; assess for edema and shortness of breath.

RATIONALE: Fluid retention can lead to weight gain and can cause or exacerbate congestive heart failure.