Dopamine Agonist and SGLT-2 Inhibitors – Oral Antidiabetic Medications (Nursing)

00:01 Our seventh family are the dopamine agonist.

00:04 Now, note Nurse Natalie at the bottom of the screen there.

00:07 See her expression? That's to remind you.

00:09 We're not exactly sure how these medications work.

00:14 We know they are helpful, but we're not exactly sure how they work.

00:17 We've just got a couple of good guesses.

00:19 That's not uncommon in the CNS, the central nervous system.

00:23 Even with our psych drugs and other CNS medications, it's so complex, we're not exactly clear how they work.

00:30 But, we use this one anyway, it's bromocriptine, is what the name is, the generic name, when it's use to treat diabetes.

00:38 Now it has other names, or aliases, when it's used to treat Parkinson's or hyperprolactinemia, which means that extra prolactin.

00:47 So, we use the same generic compound to treat Parkinson's and hyperprolactinemia.

00:56 So, we think it might reverse the hypothalamus' drive to raise blood glucose, and the triglycerides and the free fatty acids, but again, that's just a really good guess.

01:06 We're not exactly sure, at this point.

01:08 But since it messes with your CNS system, drowsiness can be a problem.

01:13 Here's one that will get your attention.

01:15 Remember that it works in the CNS system, it can exacerbate psychosis.

01:21 That's a significant side effect.

01:23 Not everyone experiences it, but if they have a mental health history of psychosis, this can definitely make it worse.

01:30 You can also have some issues with orthostatic hypotension.

01:33 Remember, if you're going from lying to sitting, or sitting to standing, you want to do that slowly, so your body can acclimate.

01:43 Now, the eighth family is the sodium-glucose co-transporters 2s.

01:48 Remember, we're kind of excited about these because research is starting to support that these don't only help type 2 diabetics, they might be very helpful with the type 1 diabetics.

01:58 We'll not replace insulin, but it might really help them have more effective treatment plans.

02:04 Okay.

02:05 This may be something that you weren't really aware of, because a lot of people are surprised to learn that the kidneys are -- really play an important role in helping to maintain the glucose balance in the body.

02:15 See, they decide what to filter and reabsorb, especially with glucose.

02:20 So the SGLTs -- remember, that's what it's in our name -- they're the transporters.

02:26 They have the majority of the responsibility of reabsorbing the glucose.

02:30 So if we block their action, what do you think's going to happen? SGLT-2 inhibitors block the reabsorption of glucose.

02:39 So, if it blocks the reabsorption of glucose back into the body, it's going to leave the body in the urine.

02:45 So you're going to have a lot more glucose leaving in the urine, and a lot more calories.

02:50 That's a cool side effect.

02:52 Now, we use it with type 2 patients and there's ongoing issues of research with type 1 patients.

02:58 So remember, I keep bringing that up because it's such a cool development.

03:03 So, these medications help -- they block the action so glucose is not reabsorbed.

03:08 You pee it out in your urine.

03:11 Okay.

03:11 Remember that we've got a lot more glucose leaving the body through the urine, so you'll end up with a risk for orthostatic hypotension.

03:19 Now because of that extra sugar or glucose in your urine, that environment becomes really friendly to fungus, so you're at a risk for fungal infections, for females, in particular.

03:30 Also at risk for UTIs -- urinary tract infections -- and polyuria; having to go to the bathroom a lot.

03:38 So this one has some very unusual side effects.

03:42 Just try to remember that more glucose leaves the body through the urine, and that's why we end up with orthostatic hypotension, a risk for a fungal infections, UTIs, and polyuria.