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NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency


glipizide Glucotrol XL Antidiabetics, 5 mg PO daily
sulfonylureas
Peak Onset Duration Normal dosage range
1-2 hr 15-30 min up to 24 hr 5 mg/day initially, increased as needed (range 2.5-40
mg/day); XL dosage form is given once daily. Doses >15
mg/day may be given as 2 divided doses of regular-release
product (not XL). (Geriatric Patients ): 2.5 mg/day
initially.
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Diabetes mellitus solutions
N/A

Mechanism of action and indications Nursing Implications (what to focus on)


(Why med ordered) Contraindications/warnings/interactions
Lowers blood sugar by stimulating the release of Hypersensitivity. Hypersensitivity to sulfonamides (cross-
insulin from the pancreas and increasing the sensitivity may occur). Insulin-dependent diabetics.
sensitivity to insulin at receptor sites. May also Diabetic coma or ketoacidosis. Severe renal, hepatic,
decrease hepatic glucose production. thyroid, or other endocrine disease. Uncontrolled
infection, serious burns, or trauma. Use cautiously in:
Severe cardiovascular or hepatic disease. Geriatric patients
(increased sensitivity; dosage reduction may be required).
Severe renal disease (increased risk of hypoglycemia).
Infection, stress, or changes in diet may alter requirements
for control of blood sugar. Impaired thyroid, pituitary, or
adrenal function. Malnutrition, high fever, prolonged
nausea, or vomiting.
Common side effects
Photosensitivity, hypoglycemia, APLASTIC ANEMIA
Interactions with other patient drugs, OTC or Lab value alterations caused by medicine
herbal medicines (ask patient specifically) Monitor serum glucose and glycosylated hemoglobin
periodically during therapy to evaluate effectiveness of
E treatment. Monitor CBC periodically during therapy.
f Report ↓ in blood counts promptly. May cause an ↑ in
f AST, LDH, BUN, and serum creatinine.
e Be sure to teach the patient the following about this
c medication
t Instruct patient to take medication at same time each day.
i Take missed doses as soon as remembered unless almost
v time for next dose. Do not take if unable to eat. Explain to
e patient that this medication controls hyperglycemia but
n does not cure diabetes. Therapy is long term. Review signs
e of hypoglycemia and hyperglycemia with patient. If
s hypoglycemia occurs, advise patient to drink a glass of
s orange juice or ingest 2-3 tsp of sugar, honey, or corn syrup
dissolved in water or an appropriate number of glucose
m tablets and notify health care professional. Encourage
a patient to follow prescribed diet, medication, and exercise
y regimen to prevent hypoglycemic or hyperglycemic
episodes. Instruct patient in proper testing of serum
b glucose and ketones. These tests should be closely
e monitored during periods of stress or illness and health
care professional notified if significant changes occur.
↓ May occasionally cause dizziness or drowsiness. Caution
patient to avoid driving or other activities requiring
b alertness until response to medication is known.
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Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Observe for signs and symptoms of med? Control of blood glucose
hypoglycemic reactions (sweating, Overdose is manifested by symptoms levels without the
hunger, weakness, dizziness, tremor, of hypoglycemia. Mild hypoglycemia appearance of hypoglycemic
tachycardia, anxiety). Patients on may be treated with administration of or hyperglycemic episodes.
concurrent beta-blocker therapy may have oral glucose. Treat severe
very subtle signs and symptoms of hypoglycemia with IV D50W
hypoglycemia. Assess patient for allergy followed by continuous IV infusion of
to sulfonamides. more dilute dextrose solution at a rate
sufficient to keep serum glucose at
approximately 100 mg/dl. Signs and
symptoms of allergy to sulfonylureas.