Page 353 - Critical Care Nursing Demystified

338 CRITICAL CARE NURSING DeMYSTIFIED

sugar levels, wearing a Medical Alert I.D. bracelet, and signs and symptoms of
hypo- and hyperglycemia. Signs of hypoglycemia can resemble alcohol intoxi-
cation or drunkenness. Hypoglycemia can be quickly reversed by drinking a
fast-acting fruit juice or soft drink. Commercial glucose gels and tablets can be
purchased and carried around in the event of a hypoglycemic reaction.
Drug Therapy Oral antidiabetic medications are listed in Table 7–6.

TABLE 7–6 Classes of Drugs to Improve Control of Type 2 DM
Class Characteristics Drug Names
Sulfonylureas – first Increase insulin production Orinase (tolbutamide),
generation from the pancreas Dymelor (acetohexamide),
For these drugs to be Tolinase (tolazamide),
effective, the patient must and Diabinese
still have some of his or her (chlorpropamide)
own circulating insulin.
Sulfonlyureas – Have fewer side effects and Glucotrol, Glucotrol XL
second generation are more potent, but more (glipizide), Micronase, Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
costly than first-generation DiaBeta, Glynase
sulfonlyureas (glyburide), Amaryl
(glimepiride)
Meglitinides Produce a more rapid and Prandin (repaglinide)
shorter-acting release of and Starlix (nateglinide)
insulin from the pancreas
Teach the patient to take
these oral meds 30 minutes
before each meal or right at
mealtime because they are
so short acting
Biguanide Reduces glucose production Glucophage (metformin)
by the liver Glucovance is a combi-
Can be used alone or in nation of metformin with
combination with insulin or glyburide.
other sulfonylureas Metformin combined
with rosiglitazone
produces Avandamet and
metformin combined
with glipizide produces
Metaglip
a-Glucosidase Delay the absorption of Acarbose (Precose) and
inhibitors glucose from the Miglitol (Glyset)
gastrointestinal tract