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  • [::..archive..::]
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    :: Saturday, July 26, 2003 ::

    medications for diabetes mellitus

    first and second generation sulfonylureas and nonsulfonylureas

    first generation sulfonylurea
    short acting

    tolbutamide (orinase)

    intermediate acting

    acetohexamide (Dymelor)
    tolazamide (Tolinase)

    long acting

    Chlorpropramide (Diabenese)

    second generation sulfonylureas

    Glipizide (glucotrol, Glucotrol XL)
    glyburide (Diabeta, Micronase, Glynase)
    Glimipiride (Amaryl)

    nonsulfonylureas

    Biguanide

    metformin (glucophage)

    Alpha Glucosidase Inhibitor

    Acarbase (Precose)
    Miglitol (Glyset)

    Thiozolidinediones

    Troglitazone (Rezulin)
    pioglitazone (Actos)
    Rosiglitazone (Avandia)

    meglitinide

    Rapaglinide (Prandin)

    Insulin and Oral hypoglycemic medications

    Descriptions

    Insulin increasesss glucose transport into cells and promotes conversion of glucose to glycogen, decreasing serum glucose levels.

    oral hypoglycemic agentss stimulate the pancrease to produce more insulin and increase the sensitivity of peripheral receptors to insulin, thereby decreasing serum glucose levels.

    Contraindications and concerns

    insulin is contraindicated in clients with hypersenstivity
    oral hypoglycemic agents are contraindicated in type 1 diabetes mellitus and in those individuals allergic to sulfonylureas.
    sulfonylureas can affect cardiac function, oxygen consumption and can lead to cardiac arrhythmias.
    use of hypoglycemic medications with beta-adrenergic blocking agents mask signs and symptoms of hypoglycemia.
    anticoagulants, chloramphenicol (chloromycetin), clorfibrate (Atromid-s), salicylates, mononamine oxidase inhibitors (MAOIs), pentamidine (pentam 300), and sulfonylureas may cause hypoglycemia.

    corticosteriods, sympathomimetics, thiazide diuretics, phenytoin (dilantin), thyroid preparations, oral contraceptives, and estrogen compounds, may cause hyperglycemia.

    side effects of the sulfonylureas include gastrointestinal symptoms, and dermatological reactions,; hypoglycemia can occur when an excessive dose is administered or when meals are omitted or delayed. food intake is decreased or activtity is increased.

    Chlorpropramide (Diabenese) can cause a disulfiram (Antabuse) type reaction when alcohol is ingested.

    oral hypoglycemic medications:-

    Are prescribed for clients with type 2 diabetes

    sulfonylureas stimulate the beta cells to produce more insulin

    nonsulfonylureas affect the hepatic and GI production of glucose and can be used in combination with a sulfonylurea.

    implementation:-

    assess the client's knowledge of diabetes mellitus and the use of oral antidiabetic agents.

    obtain a medication history regarding medications that the client is currently taking
    monitor vital signs and blood glucose levels.
    instruct the client to recognize signs and symptoms of hypoglycemia and hyperglycemia.
    instruct the client to avoid over the counter medications unless prescribed by physician.
    instruct the client not to ingest alcohol with sulfonylureas.
    instruct the client that insulin may be needed during times of stress, surgery or infection.
    instruct the client in the necessity of compliance with prescribed medication.
    advise teh client to wear a medic alert bracelet.

    tomorrow, i will go over insulin and how to administer it.

    :: Sindhu's Medical News @ 10:45 PM [+]

    ...
    :: Friday, July 25, 2003 ::
    tomorrow i will post the use and side effects of some of the drugs that were mentioned here.

    :: Sindhu's Medical News @ 12:09 AM [+]

    ...
    guide to care for patients with type 2 diabetes

    what is type 2 diabetes?

    when you eat, your body breaks down food into a fuel called glucose (sugar). your pancreas makes insulin to help sugar enter your body's cells. then the sugar can be used for energy. when you have type 2 diabetes, the sugar in the blood stream cannot get into the body's cells. this can happen because the body is not making enought insulin or your body's cells no longer recognize it. as a result, teh cells don't get the energy they need and sugar builds up to a level that is higher than normal.

    how does my health care provider know if i have diabetes?

    your health care provider will order tests if he or she suspectws that you have diabetes. two types of test are used to determine the cause of diabetes:- the fasting plasma glucose test (FPG) and the oral glucose tolerance test (OGTT). both test need you to fast overnight.

    your health care provider will also draw blood to measure your average blood sugar level over a 3 month period. this test is called a hemoglobin A1c Test.

    symptoms of hight blood sugar (diabetes)

    weakness, tiredness, fatigue
    blurred vision
    excessive thirst
    frequent urination
    sudden weight loss
    inability to concentrate
    sexual problems
    slow healing skin infections, cuts, or sores
    loss of coordination
    numbness or tingling in the hands or feet
    excessive weight.

    symptoms of low blood sugar

    sudden onset of symptoms
    poor coordination
    moodiness
    pale skin
    confusion
    inablity to concentrate
    sudden hunger
    sweating
    trembling

    normal blood sugar:- 70 - 150 mg/dl
    prediabetes:- 140 - 200 mg/dl
    diabetes:- 200 mg/dl and over

    FPG (fasting plasma glucose)

    normal:- < 110 mg/dl
    prediabetes:- 111-125 mg/dl
    diagnosis of diabetes: FPG > 126 mg/dl

    what can i do to keep my blood sugar level within the normal range?

    you'll have diabetes for the rest of your life but you should not let it control you.

    here are a few things that you can do to control your diabetes:

    blood sugar monitoring.

    blood sugar monitoring should be made a part of your normal morning daily routine.

    your physician may advise you to check your sugar before eating meals. these readings will give your primary care physician an idea of how your treatment plan is working. let your physician about your results. look out for trends to see how your blood sugar works at different times of the day. for example, today morning your blood sugar level was 130 mg/dl before breakfast, compare it to when you take it before lunch and see if it is slightly higher or lower. your physician will need to know how you are progressing and decide if your treatment plan needs to have some modifications.


    eating right.

    the food that you eat has a direct effect on your blood sugar level. it is imporant to keep a diet plan handy so as to remind you what to eat and when to eat. a dietitian can help you in creating this plan. he or she will also tell you why your diet should include certain types of foods such as fruits and leafy vegetables and why it is best to eat a low fat diet. you will also learn to limit your use of table salt. you need not have to give up the foods you enjoy completely. you can enjoy them in moderation.

    staying active.

    exercise will help your body burn off excessive sugar more quickly. it may also aid in helping your body respond better to insulin. exercise will help to lower your blood sugar. walking, swimming, jogging are good exercises to do everyday for 30 minutes to a hour. check with your health care provider before starting an exercise program as togther you both can create a program that works out best for you.

    coping with stress.

    the body responds to stress by raising blood sugar levels and new ways must be found to cope with stress. when feeling stress, take a five minute break, stretch, breathe deeply, listen to music and take a bath. be sure to keep in touch with a network of close friends.

    what medications can i take to control my blood sugar?

    your physician may put you one or more oral medications to help control your blood sugar level. Amaryl and Glyburide are two drugs that are prescribed by most physicians. these two drugs enable the pancreas to make more insulin.
    sulfonylureas can cause the pancreas to make more insulin which then causes hypoglycemia (low blood sugar). there are the newer classes of sulfonylureas which are less likely to cause low blood sugar. Glucophage (metformin) is another drug that is prescirbed by the physician. Avandia and Actos are the other drugs your physician may order for you. Actos and Avandia are also called insulin sensitizers, these drugs make your body recognize insulin. if you have a history of heart disease, these drugs should be avoided as they may cause you to retain water. you will also need to have frequent liver function tests to determine if your liver is working well. Precose and Glyset may be prescribed to prevent your small intestine from taking in glucose. These drugs are taken with food. you may have gas and stomach pain when taking them. you may have gas and bloating when taking them. you should avoid these drugs if inflammatory bowel disease is present.


    :: Sindhu's Medical News @ 12:08 AM [+]

    ...
    :: Wednesday, July 23, 2003 ::
    Hi Sindhu from Ann Stewart
    This blog is for you.
    Check the comment box.

    :: Sindhu's Medical News @ 1:10 AM [+]

    ...

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