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Antidiabetic Agents

Antidiabetic garbages are a order of garbage structurally unconnected to sulfonylureas and are efficient when used in concert forthcoming a period insulin or sulfonylureas. These garbages conceive alpha-glucosidase restrainors, biguanides, dipeptidyl peptidase-4 (DPP-4) restrainors, rational amylin, incretin mimetics, meglitinides, and thiazolidinediones.

Antidiabetic Agents: Common and Infamy Names

Here is a table of habitually encountered other antidiabetic substitutes, their common names, and infamy names:
Classifications Generic Name Brand Name
Alpha-glucosidase restrainors acarbose miglitol Precose, Glyset
miglitol Glyset
Biguanide metformin Glucophage
Dipeptidyl peptidase-4-inhibitors linagliptin Tradjenta
saxagliptin Onglyza
sitagliptin Januvia
Human amylin pramlintide acetate Symlin
Incretin mimetics exenatide Baraclude
liraglutide Victoza
Meglitinides nateglinide Starlix
repaglinide Prandin
Thiazolidinediones pioglitazone Actos
rosiglitazone Avandia

Therapeutic Action

The desired and profitable action of other antidiabetic substitutes:
  • Alpha-glucosidase restrainors acarbose and miglitol restrain alpha-glucosidase, an enzyme that breaks down glucose for parching. Therefore, they stay the parching of glucose. They own simply a placid consequence on glucose levels and do not improve insulin secretion. They are associated forthcoming a period cruel hepatic toxicity and GI pain.
  • Biguanide metformin retrench the evolution and acceptions the uptake of glucose. It is efficient in lurid blood glucose and does not purpose hypoglycemia as the sulfonylureas do. It has been associated forthcoming a period harvest of lactic acidosis and GI pain.
  • Meglitinides nateglinide and repaglinide are newer substitutes that act affect sulfonylureas to acception insulin discharge.
  • Synthetic rational amylin pramlintide efforts to modulate gastric emptying forthcoming a moderation to purpose a tenderness of plethora or satiety. It as-well prevents the postmoderation melt in glucagon that usually elevates glucose levels. Rational amylin is a hormone manufactured by beta cells in the pancreas that is expressive in predominant postmoderation glucose levels. It should not be used when enduring is unqualified to eat.
  • Incretin mimetics exenatide and liraglutide imitate the consequences of GLP-1: improvement of glucose-dependent insulin secretion by the beta cells in the pancreas, depression of rich glucagon secretion, and tardyed gastric emptying to aid steady and inferior dignity glucose levels.
  • DPP-4 restrainors lina-, saxa-, and sitagliptin tardy the breakdown of GLP-1 to continue the consequences of acceptiond insulin secretion, retrenchd glucagon secretion, and tardyed GI emptying.
  • Thiazolidinediones pioglitazone and rosiglitazone retrench insulin opposition.

Indications

Other antidiabetic substitutes are confused for the forthcoming medical requisites:
  • Biguanide metformin is current for use in conclusion 10 years of age and older. It is as-well being used in the texture of women forthcoming a period polycystic ovarian syndrome (PCOS).
  • Meglitinides nateglinide and repaglinide are used to inferior postprandial glucose levels bepurpose they are rapid-acting and forthcoming a period a very near half-life. They are fascinated harmonious anteriorly moderations.
  • Thiazolidinediones pioglitazone and rosiglitazone are used in concert forthcoming a period insulin, metformin, and sulfonylureas in endurings forthcoming a period insulin opposition.
  • Bromocriptine, a dopamine agonist used to discuss Parkinson’s illness was current in 2009 as a CNS similarity to discuss pattern 2 diabetes.

Pharmacokinetics

Here are the diagnosis interactions of other antidiabetic substitutes and the substance in stipulations of parching, division, metabolism, and excretion:
Route Onset Peak Duration
Oral Slow 2-2.5 h 10-16 h
T1/2: 6.2 h and then 17 h Metabolism: liver Excretion: urine

Contraindications and Cautions

The forthcoming are contraindications and calculating for the use of substitutes to guide dignity glucose level:
  • Allergy to sulfonylureas and other antidiabetic substitutes. Avoid hypersensitivity reactions
  • Type 1 diabetes. These endurings do not own functioning beta cells and would own no behoof from the garbage.
  • Pregnancy and lactation. Potential irrelevant consequence on the fetus or neonate.

Adverse Effects

Use of other antidiabetic substitutes may remainder to these irrelevant consequences:
  • Common irrelevant consequences conceive hypoglycemia, lactic acidosis, GI disestablish, nausea, anorexia, diarrhea, heartburn, and allergic husk reaction.
  • Pioglitazone is strongly linked forthcoming a period an acceptiond destroy of bladder cancer if it is used for balance 1 year.
  • Rosiglitazone is linked forthcoming a period acceptiond destroy of cardiovascular problems.

Interactions

The forthcoming are garbage-garbage interactions confused in the use of other antidiabetic substitutes:
  • decreased excretion forthcoming a period garbages that acidify urine

Nursing Considerations

Nursing considerations are the identical forthcoming a period sulfonylureas.

Practice Quiz: Antidiabetic Agents

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Text Mode: All questions and counterparts are abandoned on a individual page for balbutiation and counterparting at your own tread. Be infallible to grasp a pen and disquisition to transcribe down your counterparts. 1. Which of the forthcoming exerts its consequence by restraining the enzyme that breaks down glucose for parching? A. Miglitol B. Metformin C. Pramlintide D. Linagliptin 1. Answer: A. Miglitol The enzyme that breaks down glucose for parching is designated alpha glucosidase. Drugs subordinate alpha glucosidase restrainors conceive acarbose and miglitol. 2. This antidiabetic substitute efforts best in endurings forthcoming a period insulin opposition. A. Biguanides B. Dipeptidyl peptidase-4 restrainors C. Thiazolidinediones D. Meglitinides 2. Answer: C. Thiazolidinediones Thiazolidinediones pioglitazone and rosiglitazone effort by decreasing insulin opposition. 3. This antidiabetic garbage is as-well used in women forthcoming a period polycystic ovarian syndrome. A. Acarbose B. Metformin C. Rosiglitazone D. Nateglinide 3. Answer: B. Metformin 4. Which antidiabetic substitute efforts by modulating gastric emptying forthcoming a moderation to purpose a tenderness of plethora? A. Incretin mimetics B. Meglitinides C. Rational amylin D. Biguanides 4. Answer: C. Human amylin Synthetic rational amylin pramlintide efforts to modulate gastric emptying forthcoming a moderation to purpose a tenderness of plethora or satiety. It as-well prevents the postmoderation melt in glucagon that usually elevates glucose levels. Rational amylin is a hormone manufactured by beta cells in the pancreas that is expressive in predominant postmoderation glucose levels. It should not be used when enduring is unqualified to eat. 5. Use of pioglitazone for balance a year is linked forthcoming a period which requisite? A. Loss of efficientness of the garbage B. Bladder cancer C. Esophageal cancer D. Kidney failure 5. Answer: B. Bladder cancer Pioglitazone is strongly linked forthcoming a period an acceptiond destroy of bladder cancer if it is used for balance one year.

References and Sources

References and sources for this pharmacology train for Antidiabetic Agents:
  • Karch, A. M., & Karch. (2011). Focus on nursing pharmacology. Wolters Kluwer Health/Lippincott Williams & Wilkins. [Link]
  • Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.
  • Lehne, R. A., Moore, L. A., Crosby, L. J., & Hamilton, D. B. (2004). Pharmacology for nursing custody.
  • Smeltzer, S. C., & Bare, B. G. (1992). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia: JB Lippincott.
Here are other nursing pharmacology consider trains: Gastrointestinal System Drugs Respiratory System Drugs Endocrine System Drugs Autonomic Nervous System Drugs Immune System Drugs Chemotherapeutic Agents Reproductive System Drugs Nervous System Drugs Cardiovascular System Drugs

Further Balbutiation and External Links

Recommended resources and intimation books. Disclosure: Includes Amazon adopt links.
  1. Focus on Nursing Pharmacology - Easy to thrive train for Pharmacology
  2. NCLEX-RN Garbage Guide: 300 Medications You Need to Know for the Exam - Great if you're reviewing for the NCLEX
  3. Nursing 2017 Garbage Handbook (Nursing Garbage Handbook) - Reliable nursing garbage handbook!
  4. Lehne's Pharmacology for Nursing Care - Provides key knowledge on habitually used garbages in nursing
  5. Pharmacology and the Nursing Process - Learn how to guide garbages amendly and safely!
  6. Pharm Phlash Cards!: Pharmacology Flash Cards - Flash Cards for Nursing Pharmacology

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