Medication list 1

• classification- Therapeutic: antidiabetics, hormones
• Pharmacologic: pancreatics

 indications for use- Control of hyperglycemia in patients with type 1 or type 2 diabetes mellitus

 action- Lowers blood glucose by: stimulating glucose uptake in skeletal and fat, inhibiting hepatic glucose production.  Other actions: inhibition of lypolysis and proteolysis, enhanced protein synthesis.  These are reapid-acting insulins with a more rapid onset and shorter duration than regular insulin; should be used with an intermediate or long acting insulin.

contraindications/precautions- Hypoglycemia; allergy or hypersensitivity to a particular type of insulin, preservatives, or other additives.

 Life-threatening adverse reactions/most common side effects for each medication- Endo: hypoglycemia. Local: erythema, lipodystrophy, pruritis, swelling.  Misc: allergic reactions including anaphylaxis

• classification- Therapeutic: antidiabetics, hormones
• Pharmacologic- pancreatics

 indications for use- Control of hyperglycemia in patients with type 1 or type 2 diabetes; can be used to treat diabetic ketoacidosis.  Concentrated insulin U-500: only for use in patients with insulin requirements >200 units/day. Unlabeled: treatment of hyperkalemia.

 action- Lower blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production.  Other actions: inhibition of lipolysis and proetolysis, enhanced protein synthesis.  Therapeutic: control of hyperglycemia in diabetic patients. 

contraindications/precautions- Hypoglycemia; allergy or hypersensitivity to a particular type of insulin, preservatives or other additives.

 Life-threatening adverse reactions/most common side effects for each medication- Endo: HYPOGLYCEMIA Local: erythema, lipodystrophy, pruritis, swelling. Misc: allergic reactions including ANAPHYLAXIS

• classification- Therapeutic: antidiabetics, hormones
• Pharmacologic: pancreatics

 indications for use- Control of hyperglycemia in patients with type 1 or type 2 diabetes mellitus

 action- lower blood glucose by: stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production.  Other actions: inhibition of lipolysis and proteolysis, enhanced protein synthesis.  Therapeutic effects: control of hyperglycemia in diabetic patients.

contraindications/precautions- Hypoglycemia: allergy or hypersensitivity to a particular type of insulin, preservatives, or other additives.  Use cautiously in: stress and infection (may temporarily increase insulin requirements) renal/hepatic impairment (may decrease insulin requirements.

 Life-threatening adverse reactions/most common side effects for each medication- Endo: hypoglycemia Local: lipdystrophy, pruritis, erythema, swelling. Misc: allergic reactions include anaphylaxis.

• classification- Therapeutic- antidiabetics, hormones
• Pharmacologic: pancreatics

 indications for use- Control of hyperglycemia in patients with type 1 or type 2 diabetes mellitus.

 action- Lower blood glucose by: stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production.  Other actions: inhibition of lipolysis and proteolysis, enhanced protein synthesis.  Therapeutic: control of hyperglycemia in diabetic patients.

contraindications/precautions- Hypoglycemia; allergy or hypersensitivity to a particular type of insulin, preservatives or other additives.  Use cautiously in stress and infection, renal/hepatic impairment; pregnancy may temporarily increase insulin requirements.  Children <6 safety not established.  

 Life-threatening adverse reactions/most common side effects for each medication- Endo: hypoglycemia Local: lipodystrophy, pruritis, erythema, swelling.  Misc: allergic reactions including anaphylaxis.

• classification- Therapeutic: antidiabetics
• Pharmacologic: sulfonylureas

 indications for use- Control of blood glucose in type 2 diabetes mellitus when diet therapy fails.  Require some pancreatic function.

 action- Lower blood glucose by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites.  May also decrease hepatic glucose production.  Therapeutic effects: lowering of blood glucose in diabetic patients.  

contraindications/precautions- Hypersensitivity; hypersensitivity with sulfonamides, type 1diabetics; diabetic coma or ketoacidosis, concurrent use of bosentan. 

 Life-threatening adverse reactions/most common side effects for each medication- CNS: dizziness, drowsiness, headache, weakness GI: constipation, cramps, diarrhea, drug induced hepatitis, heartburn, increased appetite, nausea, vomiting DERM: photosensitivity, rashes.  ENDO: hypoglycemia F and E: hyponatremia Hemat: aplastic anemia, argranulocytosis, hemolytic anemia, leukopenia, pancytopenia, thrombocytopenia

• classification- Therapeutic: antidiabetics
• Pharmacologic: meglitinides

 indications for use- Type 2 diabetes mellitus, with diet and exercise; may be used with metformin, rosiglitazone, or pioglitazone.

 action- Stimulates the release of insulin from pancreatic beta cells by closing potassiium channels, which result in the opening of calcium channels in beta cells.  This is followed by release of insulin.  Therapeutic: lowering of blood glucose levels.

contraindications/precautions- Hyeprsensitivity; Lactation: lactation; diabetic ketoacidosis; type 1 diabetes; concurrent use of gemfibrozil.  Use cautiously in impaired liver function, severe renal impairment, geri: consider age related decrease in renal/hepatic;cardiovascular functions.  OB, Pedi: ssafety not established; insulin recommended to control diabetes during pregnancy.

 Life-threatening adverse reactions/most common side effects for each medication- CV: angina, chest pain. Endo: HYPOGLYCEMIA, hyperglycemia

• classification- Therapeutic: antidiabetics
• Pharmacologic: biguanides

 indications for use- Management of type 2 diabetes mellitus; may be used with diet, insulin, or sulfonyluera oral hypoglycemics.

 action- Decreases hepatic glucose production.  Decreases intestinal glucose absorption.  Increases sensitivity to insulin.  Therapeutic effects: maintenance of blood glucose.

contraindications/precautions- Hypersensitivity; metabolic acidosis; dehydration, sepsis, hypoxemia, hepatic impairment, excessive alcohol use; renal dysfunction >1.5 mg/dL men or >1.4 mg/dL women.  CHF.  Use cautiously in concurrent renal disease, GERI: geriatric debilitated patients decrease dosage as required, avoid patients >80 yr unless renal function is normal.  OB, Lactation, Pedi: pregnancy, lactation or children <10 yr safety not established. 

 Life-threatening adverse reactions/most common side effects for each medication- GI: abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste.  Endo: hypoglycemia, F and E lactic acidosis MISC: decreased vitamin B12 levels.  

• classification- Therapeutic: antidiabetics
• Pharmacologic: thiazolidinediones

 indications for use- Type 2 diabetes mellitus (with diet and exercise may be used with metformin, sulfonylureas, or insulin.

 action- Improves sensitivity to insulin by acting as an agonist at receptor sites involved in insulin responsiveness and subsequent glucose production and utilization.  Requires insulin for activity.  Therapeutic effects: decrease insulin resistance resulting in glycemic control without hypoglycemia.

contraindications/precautions- Hypersensitivity type 1 diabetes.  Diabetic ketoacidosis; clinical evidence of active liver disease or increased ALT; OB, Lactation: insulin should be used to control blood glucose levels; Pedi: children  Use cautiously in edema; CHF, hepatic impairment; increase distal upper and lower limb fractures; women with childbearing potential.

 Life-threatening adverse reactions/most common side effects for each medication- CV: CHF, edema EENT: Macular edema GI: hepatitis, increased liver enzymes.  Hemat: anemia Misc: fractures (arm, hand, foot) in female patients.  

• classification- Therapeutic: hormones
• Pharmacologic: pancreatics

 indications for use- Acute management of severe hypoglycemia when administration of glucose is not feasible.  Facilitation of radiographic examiniation of GI tract.  Unlabeled use: antidote to: beta blockers, calcium channel blockers.  

 action- Stimulates hepatic production of glucose from glycogen stores (glycogenolysis).  Relaxes the musculature of the GI tract (stomach, duodenum, small bowel and colon), temoporarily inhibiting movement.  Has positive inotropic and chronotropic effects.  Therapeutic: Increase in blood glucose.  Relaxation of GI musculature, faciliating radiographic examination.

contraindications/precautions- Hypersensitivity; pheochronocytoma; some products contain glycerin and phenol, avoid use in patients with hypersensitivity to these ingredients.  Use cautiously in: History suggestive of insulinoma or pheochromocytoma; prolonged fasting; starvation, adrenal insufficency or chronic hypoglycemia; when used to inhibit GI motility, use cautiouslyin geriatric patient with cardiac disease or diabetes.  OB: should be used during pregnancy only if clearly needed.  Lactation safety not established. 

 Life-threatening adverse reactions/most common side effects for each medication- CV: hypotension, GI: nausea, vomiting MISC: hypersensitivity reactions including anaphylaxis.