Now, oral hypoglycemics. I've listed 6 categories for you here.
I want you to be able to recognize these names and know what they're used for.
So this is another slide you wanna come back to
and review if some of these names seem unfamiliar to you.
I've got the families here and how they work but kind of generally overall,
they're either gonna make the patient more sensitive to insulin
or they're gonna step up the amount of insulin that's available in their body.
So I've got that for you there. I'm not gonna spend a lot of time breaking that down.
Just review those, the ones that are unfamiliar to you,
you wanna spend some extra time taking a look at them.
I wanna dive into a little bit about the sub-q injectable drugs for diabetes.
Now, here's the one you have listed there.
We got a little syringe there to remind you but this is a supplement to mealtime insulin.
So type 1 or type 2 might use this stimulant or pramlintide.
You see that generic name and the trade name right there.
So it delays gastric emptying.
It suppresses the glucagon release and it decreases postprandial hyperglycemia.
So this can really help us with specific patients.
This would be something that the health care provider would identify as a need.
So this is a sub-q injectable medication that's not insulin but we use it with insulin.
But the adverse effects: severe hypoglycemia and nausea. Why?
Look back to that mechanism of action. Ah, yeah.
It delays gastric emptying and it suppresses glucagon release.
Well, that makes obvious sense because anything a drug does well,
it can do over well and that's definitely an example.
Now, we don't want the patients to take alcohol with this medication
so that's a very important patient education piece.
So here's another one, another sub-q, exenatide. It's also adjunctive therapy.
That means we use it with other medications to improve glycemic control.
This is for type 2 diabetics. It's a supplement. Kind of like the actions of metformin.
Now, metformin is one of the most common oral medication that's given
so you've probably heard that name before.
But this is similar to metformin or sulfonylureas only it's in an injectable format.
It does the same thing. Delays gastric emptying, it suppresses the glucagon release,
and it stimulates glucose-dependent release of insulin.
So that's kinda cool which is why I wanted to highlight these medications
in addition to the chart that we gave you on the other hypoglycemics.
Now, the adverse effects. Let's see if this makes sense. It's got hypoglycemia.
Now you have that with sulfonylureas, you don't have it wit metformin.
That's probably one of the main reasons that we give so much metformin.
If a patient's blood sugar can be controlled with oral medications,
metformin only kicks in when it's needed.
Hypoglycemia's not a risk with that.
But hypoglycemia is a risk with the sulfonylureas and with exenatide.
It also has the gastrointestinal effects.
We expect that and we don't want you to have alcohol.
Okay, here's the point where you get to look back in your notes
and say looking at these medications,
what things are the same that I can chunk together
to be thinking about with sub-q injectable drugs.