Oral antidiabetic medications - Sulfonylureas and meglitinides: Nursing pharmacology

Sulfonylureas and meglitinides are medications used to treat type two diabetes. Mellitus type two diabetes is characterized by insulin resistance, which is when tissue cells have trouble responding to insulin.

In order to use glucose from the blood. As a result, tissue cells starve for energy despite having high blood glucose levels, which is called hyperglycemia.

Now, sulfonylureas can be classified into 1st and 2nd generation and are easy to recognize because they all have the suffix and include glimepiride, glipiZIDE and glyBURIDE.

On the other hand, meglitinides have the suffix glinide and include repaglinide and nide. Ok.

Now, both sulfonylureas and meglitinides are given orally and once administered. They both act on the pancreas by inhibiting ATP sensitive potassium channels on the membrane of pancreatic beta cells.

As a result, these medications initiate a cascade of events that stimulate the pancreatic beta cells to secrete more insulin.

Ultimately leading to a decrease in blood glucose levels. The most common side effects of both classes of medication are hypoglycemia and weight gain.

Other notable side effects of sulfonylureas include hepatotoxicity, leukopenia and thrombocytopenia. While meglitinides commonly cause nausea, diarrhea and indigestion.

As far as contraindications, go both sulfonylureas and meglitinides should not be used in clients with type one diabetes, mellitus or those experiencing diabetic ketoacidosis or DKA.

Since these medications will be ineffective in patients with no pancreatic beta cell function. In addition, some of these medications should be used with caution during pregnancy and breastfeeding as well as in Children or elderly adults.

Finally, precautions for these medications include hepatic or renal disease. All right, if a client with type two diabetes is prescribed an oral antidiabetic medication such as sulfonylurea or meglitinide.

Be sure to review their most recent laboratory test results including blood glucose hemoglobin A one CCBC electrolytes as well as their renal and hepatic function.

Next, explain how the medication works in their pancreas to lower their blood glucose level. Be sure to remind your client that the medication is most effective when combined with an anti diabetic regimen, which includes following a low carbohydrate and high fiber diet, regular physical activity and frequent blood glucose monitoring.

Next, review with your client, the symptoms of hyperglycemia such as fatigue, blurred vision, increased thirst, appetite and urination.

If the client develops any of these symptoms, advise them to check their blood glucose level and contact their healthcare provider immediately, then review the symptoms of hypoglycemia such as hunger, headache, fatigue tremors, dizziness and confusion.

If the client develops any of these instruct them to check blood glucose level, followed by consuming a source of glucose such as a half cup of juice, three glucose tablets or approximately 15 g of sugar and then check blood glucose again after 15 minutes.

Ok. If your client is prescribed the sulfonylurea glipiZIDE, teach them to take their medication once daily, 30 minutes before the first meal of the day, then let them know that they should avoid consuming alcohol since it can increase the hypoglycemic effects of glipiZIDE and may cause a disulfiram like reaction characterized by flushing palpitations and nausea if these occur, stress the importance of contacting their healthcare provider right away.

Now, if your client is prescribed a meglitinide, such as repaglinide, instruct them to take their medication within 30 minutes of each meal and caution them to not take their medication if they're skipping a meal.

Finally, during treatment with sulfonylureas or meglitinides, be sure to monitor for side effects as well as the therapeutic response to the medication by regularly checking your client's blood glucose levels and hemoglobin A1C levels as well as periodically checking their CBC and renal and hepatic function.

All right, it's a quick recap. Sulfonylureas and meglitinides are medications used to treat type two diabetes, mellitus.

These medications work by stimulating the release of insulin from the pancreas. The most common side effects are hypoglycemia and weight gain.

Nursing considerations include performing a baseline assessment as well as monitoring for side effects and the therapeutic effect of improved glucose control.

Client teaching is focused on safe self administration as well as preventing and recognizing side effects