IX.

DRUG STUDY
DRUG NAME ACTION INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES -make sure patient knows that drugrelieves symptoms but doesnt cure disease -instruct patient about the disease and importance of following therapeutic regimen -stress that accuracy of measurement is important - advise patient not to change order in which insulins are mixed or model or brand of insulin, syringe, or needle. -teach patient that glucose and urine ketone tests provide essential guides to dosage and success of theraphy. -advise patient to avoid vigorous exercise after insulin injection.

Insulin (regular) Classification: Therapeuticantidiabetics, Pharmacologic: Pancreatics

Increases glucose transport across muscle and fat cell membranes to reduce glucose level. Helps convert glucose to glycogen; triggers amino acid uptake and conversion to protein in muscle cells; stimulates triglyceride formation and inhibits release of free fatty acids from adipose tissue; and stimulates lipoprotein lipase activity, which converts circulating lipoproteins to fatty acids.

Moderate to severe diabetic ketoacidosis or hyperosmolar hyperglycemia Mild diabetic ketacidosis Newly diagnosed diabetes. Control of hyperglycemia with humalog and longer-acting insulin in patients with type 1 diabetes Control of hyperglycemia with humalog and sulfonylureas in patient with type 2 diabetes Control of hyperglycemia with type 1 and type 2 diabetes hyperkalemia

contraindicated in patient with history of systemic allergic to pork when porcine derived products are used or hypersensitivity to any component of preparation contraindicated during episodes of hypoglycemia inhaled form is contraindicated in patient who smoke, quit smoking within past 6 months, have poorly controlled lung disease, or allergic to any of its ingredients.

GI: dry mouth METABOLIC: hypoglycemia, hyperglycemia, hypomagnesemia, hypookalemia. SKIN: rash, urticaria, pruritus, swelling, redness, stinging, warmth at injection site. RESPIRATORY: increased cough, respiratory tract infection, dyspnea, reduced pulmonary function. OTHER: lipoatrophy, lipohypertrophy, hypersensitivity reactions, anaphylaxis.

DRUG NAME

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECT

NURSING RESPONSIBILITIES -instruct patient about nature of diabetes and importance of following therapeutic regimen. - instruct patient to stop drug and immediately notify prescriber about unexplained hyperventilation, muscle pain, malaise, unusual sleepiness, or other nonspecific symptoms of early lactic acidosis. -tell patient not to change dosage without prescribers consent. -advise patient not to cut, crush, or chew extended release tablets; instead he should swallow then whole - advise patient not to take other drugs including OTC drugs, without first checking the prescriber.

Metformin Classification: Therapeuticantidiabetics, Pharmacologic: Binguanides

Decreases hepatic glucose production and intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and use)

adjunct to diet and exercise in type 2 diabetes as monotheraphy or with a sulfonylureas or insulin ( glumetza) adjunct to diet and exercise in type 2 diabetes as monotheraphy or with a sulfonylureas or insulin (fortamet) adjunct to diet tolower glucose level in patients with type 2 diabetes

contraindicated in patients hypersensitivity to drug and in those with renal disease, hepatic disease, or metabolic acidosis contraindicated in patient with heart failure requiring pharmacologic intervention and patients with conditions predisposing to renal dysfunction, CV collapse, MI, hypoxia and septicemia. Use cation when giving drug to elderly, debilitated, or malnourished patients and those with adrenal or pituitary insufficiency because of increased risk of hypoglycemia.

GI: diarrhea, nausea, vomiting, abdominal bloating, flatulence, anorexia, taste perversion. HEMATOLOGIC: megoblastic anemia METABOLIC: lactic acidosis, hypoglycemia