Exam 2: Second-Generation Sulfonylureas

Exam 2: Second-Generation Sulfonylureas

1. Nursing interventions

   • Intermittent glucose monitoring
   • Obtain baseline BUN, Cr, and LFTs
   • Continue monitoring BUN and Cr if over 65

2. Pharmacological Action

   • Stimulates release of insulin from the pancreas

3. Extra information

   • Less effective over time
   • Taken 30 minutes before breakfast

4. Pharmokinetics

   • Excreted through urine
   • Metabolized in the liver

5. Adverse effects

   • Hypoglycemia
   • Nausea
   • Heartburn
   • Photosensitivity

6. Contraindications

   • Sulfa allergy
   • Hepatic/Renal Impairment
   • Pregnancy/Lactation
   • Diabetic ketoacidosis

7. Drug interactions

   • Beta-blockers (suppress insulin release)
   • Disulfiram-like reaction
   • Drugs that can interact to cause hypoglycemia
     • sulfonamide antibiotics
     • Acute alcohol ingestion
     • NSAIDs
     • cimetidine (Tagamet)