NR 565 final Exam Latest Update Graded A+

NR 565 final Exam Latest Update Graded A+ Criteria for DM diagnosis Hemoglobin A1c ≥ 6.5% Fasting plasma glucose (FPG) ≥ 126 mg/dL (8-hour fast) 2-hour oral glucose tolerance test; common test for pregnant women ≥ 200 mg/dL Classic symptoms and random plasma glucose ≥200 mg/dL (classic symptoms: polyuria, polydipsia, unexplained weight loss) Basic overview of tx DM Step 1: lifestyle and metformin Step 2: add second job Step 3: 3 drug combo Step 4: injectable regimen possibly GLP-1 Biguanides (Metformin) black box and side effects Black box: lactic acidosis - hemodialysis can remove accumulates metformin Side effects: decreased appetite, nausea, diarrhea, vit b12, folate Monitor renal function if GFR < 30 dc drug Sulfonylureas Contraindications Pregnancy Type 1DM BF Renal and hepatic dysfunction Sulfonylureas drug examples and education -"ides" Only for type 2 diabetes Educate on s/s of hypoglycemia Meglitinides Only for type 2 dm, same as sulfonylureas, stimulate pancreatic insulin release Contraindicated in liver impairment and gemfibrozil Meglitinides drugs Glinides TZDs Only type 2 Avoid in heart failure and bladder cancer TZD drugs end in -"zones" SGLT2 inhibitors end -flozin SGLT-2 contraindications If can't get to bathroom easily Caution with vulvovaginal and uti infections SGLT 2 educate S/s hypoglycemia, UTI infections or vulvovaginal infections Stay hydrated Dipeptidyl Peptidase-4 Inhibitors end Gliptin DPP-4 inhibitors MOA increase insulin production and decrease glucose production DPP-4 inhibitors contraindications Pancreatitis DPP-4 inhibitors educates S/s hypoglycemia May see weight loss GLP-1 agonists end in Tides GLP-1 agonists 4 actions Increase dullness Delay gastric emptying Increase sensitivity to insulin Cardio protective GLP-1 agonists contraindications Pregnancy Renal dysfunction/ transplant Pancreatitis If pt has personal or family hx of thyroid carcinoma Education on GLP-1 agonist Delay gastric emptying so May effect other drugs that are taken