Mẹo Which antidiabetic drug can be taken in combination with metformin Quizlet
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Bùi Mạnh Hùng đang tìm kiếm từ khóa Which antidiabetic drug can be taken in combination with metformin Quizlet được Cập Nhật vào lúc : 2022-11-09 18:22:02 . Với phương châm chia sẻ Mẹo về trong nội dung bài viết một cách Chi Tiết Mới Nhất. Nếu sau khi Read Post vẫn ko hiểu thì hoàn toàn có thể lại phản hồi ở cuối bài để Mình lý giải và hướng dẫn lại nha.Indications: Type II Diabetes, Polycystic Ovarian Disease
Contraindications: Pregnancy, hepatic disorders, and need insulin'
- Which antidiabetic drug can be taken in combination with metformin?Which diabetic drug classes should be considered in addition to metformin?Which combination is best with metformin?Which of the following drug used in both types of diabetes?
Side effects: GI upset, diarrhea, hypoglycemia, heartburn, anorexia
Nrsg interventions: Monitor BG, monitor hepatic function, educate about diet, low carbs, higher
protein diets, may eat complex carbs, consult with diabetic educator
Which oral antidiabetic drug belongs to the biguanide class?
Acarbose (Precose)
Nateglinide (Starlix)
Pioglitazone (Actos)
Metformin (Glucophage)
Correct! Metformin (Glucophage)
There is only one drug in the biguanide class, and it is metformin.
For which patient would a biguanide antidiabetic drug be contraindicated?
A female patient who is pregnant
A newly
diagnosed type 2 diabetic
A patient with known kidney disease
A diabetic patient with some functioning pancreatic beta cells
Correct! A patient with known kidney disease
Metformin should not be given to patients with kidney disease as it can cause kidney failure.
A diabetic patient taking metformin (Glucophage) is scheduled for a radiographic scan with contrast dye. What instructions should you provide to this patient?
"Take the metformin as soon as the scan is completed."
"Stop taking the metformin least 24 hours before your scan."
"Take your metformin the morning of the scan."
"Stop your metformin the night before the scan, and resume 72 hours after the scan."
Correct! "Stop taking the metformin least 24 hours before your scan."
Metformin is to be stopped least 24 hours before radioactive dye is used and not started again until 48 hours after the test is completed.
You are teaching a diabetic patient who has been prescribed rosiglitazone about this drug. Which statement should you include in the patient's teaching plan?
"Call if you develop swelling of the legs, or weight gain."
"If you miss a dose of this drug, take two tablets for your next dose."
"You will not need to check your blood sugar when using this drug."
"Vision changes are expected with
this drug and are not of a concern."
Correct! "Call if you develop swelling of the legs, or weight gain."
The thiazolidinediones have been associated with severe cardiovascular side effects and must be used with care. Rosiglitazone can also cause fluid retention, liver problems, and macular edema. Teach patients to report swelling of the feet or ankles, or rapid weight gain to the healthcare provider.
A 48-year-old male has been diagnosed with type 2 diabetes. He has been prescribed a thiazolidinedione drug. Which precaution regarding alcohol use is important to teach this patient?
"Increase your water intake whenever you drink alcohol."
"Avoid alcohol while taking this drug."
"Only drink alcohol with a meal or shortly after a meal."
"Alcohol should be limited to 4 ounces daily."
Correct Answer "Avoid alcohol while taking this drug."
Drinking alcoholic beverages while taking thiazolidinedione can result in hyperglycemia or hypoglycemia depending on how much alcohol is ingested.
Which statement made by a diabetic patient who has been prescribed acarbose indicated an understanding as to how acarbose (Precose) prevents blood glucose levels from rising too high?
"Acarbose limits the enzyme that converts complex carbohydrates into glucose."
"Acarbose blocks the absorption of
carbohydrates and glucose in the intestines."
"Acarbose enhances the binding of insulin to its membrane receptors."
"Acarbose releases more insulin from pancreatic beta cells."
Correct! "Acarbose limits the enzyme that converts complex carbohydrates into glucose."
Acarbose is an alpha-glucosidase inhibitor. Drugs from this class work by slowing the digestion of dietary starches and other carbohydrates by inhibiting an enzyme that breaks them down into glucose. The result of this action is that blood glucose does not rise as far or as fast after a meal.
You are about to give miglitol (Glyset) to a patient with diabetes mellitus type 2. Which nursing action is most important for this patient?
Rotate the injection site on a weekly basis.
Give this drug the beginning of a meal.
Do not mix this drug in the same syringe as insulin.
Assess the patient for signs and symptoms of
heart failure.
Correct Answer Give this drug the beginning of a meal.
Miglitol is an oral antidiabetic drug from the alpha-glucosidase inhibitor class. Its action is to slow the digestion of starches and other carbohydrates in the intestinal tract. In order to be effective, it must be taken the beginning of a meal.
In teaching a diabetic patient about DPP_4 inhibitors, which symptom should you tell the patient to report as a potential serious complication from this drug?
Swelling of the lower extremities
Changes in visual acuity
Diarrhea
Abdominal pain
Correct Answer Abdominal pain
Diarrhea can be an expected side effect of this drug. However, pancreatitis is a serious complication that may occur. Symptoms of acute pancreatitis that should be taught to be reported immediately are upper abdominal radiating to the back, nausea and vomiting, fever, and rapid pulse. This is a serious adverse effect of the drug.
A young, female patient with diabetes mellitus who is taking an oral antidiabetic drug comes in for a regularly scheduled clinic appointment. She tells you that is currently taking an oral contraceptive agent for birth control. What is your best response?
"Oral contraceptives are contraindicated for diabetics."
"Oral contraceptives can be taken only if you are
on insulin."
"Oral contraceptives can be safely taken with oral antidiabetic agents."
"Oral contraceptives reduce their effectiveness of oral antidiabetic agents."
Correct! "Oral contraceptives reduce their effectiveness of oral antidiabetic agents."
Oral contraceptives and antibiotics can interact with drugs for diabetes, reducing their effectiveness.
You are teaching a patient who has been prescribed a sodium-glucose cotransport inhibitor for the treatment of diabetes mellitus type 2. The patient asks you to explain how this drug works. What is your best response?
"This drug works by inactivating normal gut hormones."
"This drug works by preventing the kidney from reabsorbing glucose."
"This drug works by making insulin receptors more sensitive to insulin."
"This drug works by preventing enzymes from breaking down starches into glucose."
Correct! "This drug works by preventing the kidney from reabsorbing glucose."
Sodium-glucose cotransport inhibitors are a new category of non-insulin antidiabetic drug that lower blood glucose levels by preventing the kidney from reabsorbing glucose that was filtered from the blood into the urine. This glucose then remains in the urine and is excreted rather than moved back into the blood.
A patient who is taking dapagliflozin (Farxiga) for diabetes mellitus type 2 has also been prescribed furosemide (Lasix) for another condition. What potential risk should you monitor for on this patient?
Risk for infection
Risk for bleeding
Risk of dehydration
Risk for fluid retention
Correct! Risk of dehydration
Combining sodium-glucose cotransport inhibitors with diuretics increases the frequency of urination increases and can result in dehydration.
A
patient is taking a sodium-glucose cotransport inhibitor for the treatment of diabetes. Which of the following laboratory values should you monitor in this patient?
Serum potassium
Serum amylase and lipase
Hemoglobin and hematocrit
Cholesterol and triglycerides
Correct! Serum potassium
Patients with diabetes are increased risk for hyperkalemia due to the presence of renal impairment, and potential use of diuretics and antihypertensives used in this population. Hyperkalemia is also potential serious adverse effect of sodium-glucose cotransport inhibitors. Monitor the patient's serum potassium level, and check for symptoms of hyperkalemia (muscle twitching, numbness and tingling, irregular heart rate).
Question 211 / 1 pts
A patient is started on exenatide (Byetta), an injectable incretin mimetic. The patient asks you how this drug will help lower blood glucose. Which is your
best response?
"This drug restores insulin secretion."
"This drug increases insulin secretion."
"This drug works to increase the duration of insulin."
"This drug works by increasing the action of glucagon."
Correct! "This drug increases insulin secretion."
Incretin mimetics act like the natural gut hormones (e.g., GLP-1) secreted in response to food in the stomach, increasing insulin secretion, decreasing glucagon secretion, and slowing the rate of gastric emptying. This results in an increase in insulin secretion, a decrease in glucagon secretion, and a slower the rate of gastric emptying.
What characteristic of insulin makes insulin a "high-alert" drug?
Insulin has a high potential for hypersensitivity reactions.
Serious harm can occur if the wrong dose is given.
Too little insulin can cause the respiratory system to become depressed.
Too much insulin can cause blood
glucose levels to increase to dangerously high levels.
Correct! Serious harm can occur if the wrong dose is given.
Insulin as a drug works very quickly. Great harm can come to a patient who receives it and does not have diabetes. Also, if too much of it is given to a patient who does have diabetes, the patient can become severely hypoglycemic and die. If too little insulin is given to a patient who has diabetes, blood glucose levels remain too high and cause organ damage.
You are preparing to teach a patient about the use of short-acting insulin. Which instruction should be stressed to the patient regarding this drug?
"Place pressure on the injection site for 5 full minutes."
"You should eat a meal within 15 minutes of giving yourself the injection."
"You should always aspirate before injecting this drug."
"You may store your insulin for 6 months room temperature."
Correct! "You should eat a meal within 15 minutes of giving yourself the injection."
Whenever short-acting insulin is given before a meal, the patient will need to eat the meal within 15 minutes of receiving the injection to prevent hypoglycemia.
A patient about to begin self-injections of insulin home asks you why insulin can only be given by injection, and not as an oral drug. What is your best
response?
"Injected insulin works faster than oral drugs to lower blood glucose levels."
"Insulin is a small protein that is destroyed by stomach acids and intestinal enzymes."
"Insulin is a "high-alert drug" and can be abused if it were available as an oral agent."
"Oral insulin has a high 'first-pass loss' rate in the liver that would require high dosages to be effective."
Correct! "Insulin is a small protein that is destroyed by stomach acids and intestinal enzymes."
Since insulin is a small protein that is easily destroyed by stomach acids and intestinal enzymes, it cannot be used as an oral drug. Most commonly it is injected subcutaneously.
You are teaching a patient with newly diagnosed diabetes about insulin. The patient asks you to explain the role of insulin in preventing hyperglycemia. What is your best response?
"Insulin plays a major role in converting complex
carbohydrates to glucose."
"Insulin allows cells to take up, use, and store carbohydrates, fat, and protein."
"Insulin prevents the kidney from excreting of glucose."
"Insulin prevents the formation of fat cells."
Correct! "Insulin allows cells to take up, use, and store carbohydrates, fat, and protein."
Insulin is called the hormone of plenty, because its release is triggered by hyperglycemia. Insulin allows cells to take up, use, and store carbohydrates, fat, and protein Many body toàn thân cells have membranes that do not allow glucose to move into the cells to participate in metabolism. When insulin binds to membrane insulin receptors, the membranes become more open to glucose, allowing it to enter.
In what way does insulin work to lower blood glucose levels?
Enhancing the enzymes that break down glucose
Helping glucose to move from the blood into cells
Converting glucose into
proteins in the liver and brain
Converting glycogen into glucose in the liver and brain
Correct! Helping glucose to move from the blood into cells
When insulin binds to insulin receptors on cells, the cells' membranes become more open (permeable) to glucose and glucose transport proteins in the cell membranes become more active. The overall result is movement of glucose into the cells, which lowers blood glucose levels.
Which term is used to indicate an elevated blood sugar (glucose) level in a patient?
Glycogen
Euglycemia
Hypoglycemia
Hyperglycemia
Correct! Hyperglycemia
Glycogen is a stored form of human carbohydrate. Euglycemia means a blood sugar level within the normal range. Hypoglycemia is a lower than normal blood sugar level.
A nursing student working with you today is learning about blood glucose control. Which statement made by the student about glucagon demonstrates an understanding of this hormone?
"Glycogen triggers the release of glucose from the liver and skeletal muscle."
"Glucagon allows the cells to use fats, protein, and carbohydrates."
Glucagon is an important hormone for energy production."
"Glucagon initiates the release of adenosine triphosphate."
THEY MISPELLED GLUCAGON
Correct Answer
"Glycogen triggers the release of glucose from the liver and skeletal muscle."
Glucagon, which is known as the hormone of starvation, is secreted from the alpha cells of the pancreas when blood glucose levels are lower than normal. Glucagon goes to the liver and triggers the breakdown of glycogen and release of glucose into the blood, raising the blood glucose level. These actions are exactly the opposite of insulin's actions.
What is the main reason that insulin is needed as drug therapy for people who have type 1 diabetes?
The beta cells of the pancreas no longer make insulin.
The alpha cells of the pancreas no longer make insulin.
The beta cells of the pancreas make too much glucagon.
The alpha cells of the pancreas make too much glucagon.
Correct! The beta cells of the pancreas no longer make insulin.
With type 1 diabetes, the beta cells of the pancreas are destroyed and no longer produce any insulin. Insulin is necessary for life, so drug therapy for type 1 diabetes requires insulin. People who have type 2 diabetes often continue to secrete insulin from their beta cells; thus extra insulin may not be needed. Drugs for this condition often work by forcing the beta cells to release the patient's own insulin.
Which statement regarding diabetes mellitus (DM) type 2 is true?
Some people with DM type 2 will need
insulin.
This type of diabetes is found in children less than 1 year of age.
Drug therapy for DM type 2 eliminates the need for diet and exercise.
DM type 2 is characterized by sudden, complete shutdown of the pancreas.
Correct! Some people with DM type 2 will need insulin.
Insulin may also be necessary for some people with DM type 2, although diet, weight reduction, and non-insulin antidiabetic drugs are often effective in maintaining good blood glucose control.
You are preparing to discuss a newly prescribed insulin stimulator with a patient. What condition would need to be present for this drug to work effectively for a diabetic patient?
The patient would need to be able to self-inject the drug.
The patient would need to be in ketoacidosis to begin this drug.
The patient would need to have diabetes mellitus type 2 to use this drug.
The patient needs to have some
functioning beta cells for this drug to work.
WRONG?? Correct Answer The patient would need to have diabetes mellitus type 2 to use this drug.
Insulin stimulators are oral drugs that lower blood glucose levels by stimulating the release of insulin stored in the beta cells of the pancreas. Therefore, the patient must have some functioning beta cells if these drugs are to work.
A patient with diabetes mellitus type 2 is prescribed glipizide (Glucotrol). You are preparing to give the glipizide to the patient. Which of the following nursing actions would be your best action when giving this drug?
Give this drug with milk.
Give this drug with a meal.
Assess the patient for signs of pancreatitis before giving this drug.
Take the patient's pulse before giving this drug.
Correct! Give this drug with a meal.
These drugs with, or just before, meals prevent hypoglycemia. If you must skip a meal, also skip the drug dose.
In reviewing the plan of care for a patient with type 2 diabetes who is overweight and likes to eat sweets, an initial goal might be to
start 10 units of regular insulin 30 minutes before each meal.
replace a snack of five filled chocolate cookies with three graham crackers.
check blood sugar after eating cookies and initiate sliding scale insulin.
remove
all carbohydrate foods and encourage only high-protein foods.
Correct! replace a snack of five filled chocolate cookies with three graham crackers.
Replacing chocolate cookies with graham crackers would be an initial step in improving weight loss and implementing a healthy lifestyle of proper nutrition and exercise.
The main factors that influence development of type 2 diabetes mellitus are
weight
and heredity.
liver disease.
enzyme deficiencies.
childhood illnesses.
Correct! weight and heredity.
Weight and heredity seem to play a role in the development of type 2 diabetes mellitus.
Uncontrolled diabetes is related to the abnormal metabolism of
carbohydrates and proteins.
proteins and fats.
carbohydrates, proteins, and fats.
carbohydrates only.
Correct! carbohydrates, proteins, and fats.
Uncontrolled diabetes causes alterations in glucose metabolism as well as abnormal metabolism of proteins and fats.
A fasting blood glucose level of 85 mg/dL would be considered consistent with
an impaired glucose tolerance.
diabetes.
normal health.
a diabetic coma.
Correct! normal health.
A blood glucose below 100 mg/dL is considered normal.
The hormone considered to act in a manner opposite to insulin is
glucagon.
somatostatin.
growth hormone.
adrenaline.
Correct! glucagon.
Glucagon is a hormone that acts in a manner opposite to insulin to balance the overall blood glucose level. It can rapidly break down stored glycogen and, to a lesser extent, fat.
Ketones are a
by-product of the metabolism of
carbohydrates.
proteins.
fats.
alcohol.
Correct! fats.
Ketones form as a by-product of fat metabolism when the supply of glucose is insufficient.
The three common, long-term complications of diabetes affect the cells of the
pancreas, liver, and spleen.
kidney, eye, and nerve tissue.
kidney, liver, and spleen.
heart, liver, and brain.
Correct Answer kidney, eye, and nerve tissue.
Long-term complications of diabetes affect the kidney (nephropathy), eye (retinopathy), and nerve tissue (neuropathy).
If a patient with type 1 diabetes has a fever and increased blood glucose levels, he or she should
drink only water until blood glucose levels drop.
adjust the insulin dose to normalize blood glucose levels.
maintain normal insulin doses and food
intake.
seek medical advice immediately.
Correct Answer adjust the insulin dose to normalize blood glucose levels.
During illness and fever, blood glucose levels often increase. Patients should increase their insulin dose to maintain blood glucose levels as close to normal as possible. They should maintain normal food intake, taking carbohydrate as liquid or soft foods if appetite is poor. They should contact a physician if the illness lasts for more than 24 hours, if fever remains high, or if blood glucose remains ≥250 mg/dL and a urine dip-stick tests shows moderate to large ketones are present.
The form of insulin that has its peak action after about 8 hours is
rapid-acting insulin.
intermediate-acting insulin.
long-acting insulin.
oral hypoglycemic insulin.
Correct! intermediate-acting insulin.
Intermediate-acting (NPH) insulin peaks after about 8 hours.
Women with a history of gestational diabetes mellitus are risk for developing
chronic kidney disease.
type 2 diabetes.
type 1 diabetes.
morbid obesity.
Correct! type 2 diabetes.
The risk for developing type 2 diabetes is significantly higher in women with a history of gestational diabetes.
For individuals with type 2 diabetes, exercise
decreases insulin efficiency.
stimulates the release of insulin.
decreases risk of cardiovascular disease.
raises blood glucose levels.
Correct Answer decreases risk of cardiovascular disease.
Exercise increases the number of insulin receptors on muscle cells. Long-term studies have shown that with type 2 diabetes, exercise helps control blood glucose and reduces the risk of cardiovascular disease, hyperlipidemia, hypertension, and obesity.
Type 2 diabetes usually appears after the age of
30 years.
40 years.
50 years.
60 years.
Type 2 diabetes usually appears after the age of 40 years but is now also being diagnosed in children.
Mr. Jones is 20 lb above his desirable weight and has type 2 diabetes. A recommendation to Mr. Jones would be to
increase
kilocalorie intake.
include between-meal snacks.
take extra food during exercise.
decrease kilocalorie intake.
Correct! decrease kilocalorie intake.
Decreasing kilocalorie intake will help Mr. Jones lose weight and control his type 2 diabetes.
A patient with type 2 diabetes eats a high-protein, very low-carbohydrate diet to try to lose weight. The main long-term concern if the patient continues this eating pattern would be
excessive weight loss.
the development of hypertension.
the development of liver disease
the development of neuropathy.
Correct Answer the development of neuropathy.
Excessive protein intakes may contribute to the development of nephropathy in patients with diabetes because disposal of extra nitrogenous waste puts unnecessary stress on the kidneys.
ALSO HTN
Which antidiabetic drug can be taken in combination with metformin?
There are six major classes of antidiabetic agents that can be combined with metformin. They are sulfonylurea (SU), thiazolidinediones (TZDs), dipeptidyl peptidase-4 inhibitors (DPP4i), sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists, and insulin.Which diabetic drug classes should be considered in addition to metformin?
Agents that can be added to metformin include sulfonylureas, meglitinides, thiazolidinediones (TZDs), or acarbose.Which combination is best with metformin?
Since metformin lowers plasma glucose without affecting insulin secretion, it is often combined with an agent stimulating insulin secretion, like a sulfonylurea. Adding a sulfonylurea to metformin has thus been the conventional and the gold standard combination therapy for decades.Which of the following drug used in both types of diabetes?
The most common biguanide is metformin (Glumetza, Riomet, Riomet ER). Metformin is considered the most commonly prescribed oral medication for type 2 diabetes, and it can also be combined with other type 2 diabetes medications. It's an ingredient in the following medications: metformin-alogliptin (Kazano) Tải thêm tài liệu liên quan đến nội dung bài viết Which antidiabetic drug can be taken in combination with metformin Quizlet
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