L6-Glucose Elevating agents.ppt
- 2. Glucose-elevating agents • Glucose-elevating agents raise blood level of glucose when severe hypoglycemia occurs at <40 mg/dL. • Two agents are used to elevate glucose: diazoxide and glucagon. 2/28/2023 2 ALICE BCM 329.
- 3. Glucose-elevating agents • Therapeutic Action • Increasing blood glucose by decreasing insulin release and accelerating the breakdown of glycogen in the liver to release glucose. 2/28/2023 3 ALICE BCM 329.
- 4. Glucose-elevating agents • Indications • Diazoxide- Oral formulations are indicated for the management of hypoglycemia; A potent antipressor..intravenous use for management of severe hypertension. • Glucagon is used to counteract severe hypoglycemic reactions. 2/28/2023 4 ALICE BCM 329.
- 5. Glucose-elevating agents Dosing and administration Oral and parenteral formulations are available The dosage is usually individualized. Review the dosage guidelines@ https://www.drugs.com/dosage/glucagen.html https://www.drugs.com/dosage/proglycem.html 2/28/2023 5 ALICE BCM 329.
- 6. Glucose-elevating agents • Pharmacokinetics for IV ROUTE ONSET PEAK DURATION IV 1min 15 min 9-20 min T1/2: 3-10 min Metabolism: liver Excretion: bile, urine 2/28/2023 6 ALICE BCM 329.
- 7. Glucose-elevating agents • Contraindications and Cautions • Diazoxide is contraindicated with known allergies to sulfonamides or thiazides. • Pregnancy and lactation. Associated with adverse effects to fetus and baby. 2/28/2023 7 ALICE BCM 329.
- 8. Glucose-elevating agents • Contraindications and Cautions • There are no adequate studies on glucagon and pregnancy, so use should be reserved for those situations in which the benefits to the mother outweigh any potential risks to the fetus. • Caution should be used in patients with renal or hepatic dysfunction or cardiovascular disease. 2/28/2023 8 ALICE BCM 329.
- 9. Glucose-elevating agents • Adverse Effects • Glucagon is associated with GI upset, nausea, and vomiting. • Diazoxide is associated with vascular effects, including hypotension, headache, cerebral ischemia, weakness, heart failure, and arrhythmias. • This is because diazoxide has the ability to relax arteriolar smooth muscle. 2/28/2023 9 ALICE BCM 329.
- 10. Glucose-elevating agents • Interactions • Diazoxide with thiazide diuretics can increase risk of toxicity because these two are structurally the same. • Glucagon with oral anticoagulants will increase anticoagulation effects. 2/28/2023 10 ALICE BCM 329.
- 11. Glucose-elevating agents • Vital interventions • Monitor blood glucose levels to evaluate the effectiveness of the drug. • Have insulin on standby during emergency use to treat severe hyperglycemia if it occurs as a result of overdose. • Monitor nutritional status 2/28/2023 11 ALICE BCM 329.
- 12. Glucose-elevating agents • Monitor patients receiving diazoxide for potential cardiovascular effects, including blood pressure, heart rhythm and output, and weight changes to avert serious adverse reactions. • Provide comfort measures to help patient cope with drug effects. • Provide patient education about drug effects and warning signs to report to enhance patient knowledge and to promote compliance. 2/28/2023 12 ALICE BCM 329.
- 13. Glucose-elevating agents • Monitor patient response to therapy (stabilization of blood glucose levels). • Monitor for adverse effects (hyperglycemia and GI distress). • Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for. • Monitor patient compliance to drug therapy. 2/28/2023 13 ALICE BCM 329.