This episode is everything Anti-Diabetic and Insulins. All of this material is being pulled from PDR (Physician's Desk Reference)

PHARMACOLOGY STUDY GUIDE: ANTIDIABETIC AGENTS

Covers Insulin, Glipizide (Sulfonylurea), Metformin (Biguanide), and Glucagon — focusing on MOA, red-flag effects, nursing priorities, and top NCLEX points.

I. INSULIN (Lispro, Aspart, Humulin R, Novolin N)

MOA: Promotes glucose uptake → stored as glycogen. Use: Type 1 DM, sometimes Type 2. Major Risk: Hypoglycemia — trembling, sweating, confusion, tachycardia. Priority: If conscious, give 4 oz OJ; if mild, check glucose first. Other Concerns: Somogyi (night hypoglycemia → AM rebound), Dawn Phenomenon (AM hyperglycemia), Lipodystrophy (rotate sites). Teach: Recognize hypo/hyper signs, store insulin refrigerated, avoid heat/light. Interactions: ↑BG—steroids, thiazides. ↓BG—MAOIs, aspirin, TCAs. NCLEX Tips: 1️⃣ Hypoglycemia = Priority. 2️⃣ Somogyi vs Dawn. 3️⃣ Store properly.

II. SULFONYLUREAS (GLIPIZIDE)

MOA: Stimulates pancreas → ↑ insulin. Use: Type 2 DM with functioning β-cells. Risk: Hypoglycemia (especially if no meal), weight gain, GI upset. Teach: Take 30 min before meals; always eat right after. Avoid: Renal/hepatic impairment. NCLEX Tips: 1️⃣ Take before meal. 2️⃣ Never skip eating. 3️⃣ Watch for hypoglycemia.

III. BIGUANIDES (METFORMIN)

MOA: ↓ hepatic glucose production, ↑ insulin sensitivity. Use: Type 2 DM (normal renal/hepatic function). Risk: Metallic taste; lactic acidosis in renal/hepatic impairment. Priority: Monitor renal/hepatic labs; hold before contrast dye studies. NCLEX Tips: 1️⃣ Liver = Target. 2️⃣ Monitor kidney. 3️⃣ Hold before procedures.

IV. HYPERGLYCEMIC AGENT (GLUCAGON)

MOA: ↑ BG via glycogenolysis (liver). Use: Severe hypoglycemia when oral glucose unavailable. Priority: Emergency only—administer IM/IV; follow with carbs when awake. NCLEX Tips: 1️⃣ Use when patient can’t take PO. 2️⃣ Fast-acting, life-saving.

Rapid Recall: 💉 Insulin: Pushes glucose in. 💊 Glipizide: Squeezes pancreas. ⚙️ Metformin: Stops liver sugar dump. 🚨 Glucagon: Brings glucose out.