00:01
Now let's talk about
drugs and low blood sugar.
00:04
These are going to fall
into two categories.
00:07
Drugs that cause hypoglycemia
and drugs that impact the
body's response to hypoglycemia.
00:13
Okay, so that's important that
you have these two categories.
00:17
Drugs that cause hypoglycemia
and drugs that impact the
body's response to hypoglycemia.
00:23
The first group I want to
talk about our beta blockers.
00:26
Now, these are drugs that impact
the body's response to hypoglycemia.
00:31
Okay, a beta blocker
is a medication that we
generally give to patients.
00:37
We want to lower their blood pressure,
and beta-blockers decrease the
workload of the heart.
00:43
So people often
take this medication
for blood pressure control
or after a heart attack.
00:48
So you with me on these
These are the - right.
00:52
So beta blockers impact
the rate of the heart
and how hard it pumps.
01:00
Now, what does that have
to do with low blood sugar?
Or remember the job of a
beta 1 receptor on your heart
is to make it pump
harder and faster.
01:09
When I give you a beta
blocker medication
that reaction is blocked.
01:15
Because normally
when I'm stressed,
epinephrine will squirt
out of my adrenal gland
race around the receptors on my heart.
01:21
They connect and this is
what happens to the heart.
01:25
Well if I'm taking a beta
blocker this epinephrine
will not be able to bind to
those receptors on my heart.
01:32
So if I wasn't
taking a beta blocker
and my blood sugar became low,
I have a really fast heart rate.
01:39
But if I'm taking
a beta blocker,
I will not show that
same fast heart rate,
because if I'm on a beta blocker,
I'm going to present differently
that sympathetic nervous
system gets blocked,
the response that
would normally happen
when epinephrine binds to
The receptors on the heart
can't happen,
because the medication has bound
to those receptors on the heart.
02:02
Okay so is that kind of
starting to ring a bell here.
02:05
So I want you to be clear.
02:07
I can have a patient
who's diabetic,
who's at risk for low blood sugar
but they're on a beta blocker,
they're not going to show
me a rapid heart rate.
02:15
They might just show me the
neuro signs of being confused
because of this medication the
heart rate won't be as elevated
and also the second piece
the glycogen breakdown
will not be a stimulated.
02:28
See that's what the sympathetic
nervous system controls
when epinephrine comes
out of my adrenal,
raises around to the
receptors on my heart
and hits what's
going on in my liver
supposed to tell it to
kick out stored glycogen.
02:43
Well, this is dampened think
of it as less of a response
if the patient is
taking a beta blocker,
so we're not going to see
the symptom of tachycardia
and the body's not going to
break up as much stored sugar.
02:56
That's two ways of beta blocker
can impact the body's
response to low blood sugar.
03:03
Now let's look at drugs that
actually cause low blood sugar.
03:07
So these are drugs that
cause hypoglycemia.
03:10
Now, there's two
groups of medications,
sulfonylureas and I've got examples
of their generic names there,
and meglitinides.
03:18
Those are so hard for me to say
but I've got the
names for you there.
03:23
Pretty cool there that you
see that they end in glinide
and glinide that makes it
easier to remember them.
03:29
Now these two groups
or categories of drugs
actually cause low blood sugar
or hypoglycemia, what we're
talking about in this video series.
03:39
So if the patient skips a meal
or this tends to occur
even more often in patients
who are older or who
have kidney disease.
03:47
So who's most at risk?
Well,
I want you to have a heads up,
this two categories of medications
will actually tend to lower
your blood sugar down to
the point of hypoglycemia.
03:58
Right? So we want to be on the
lookout for people who are elderly,
people who have kidney disease,
or someone who skips a meal.
04:05
Those are three factors that go along
with these 2 groups of medications
that can cause some pretty
significant hypoglycemia.
04:14
I’d also like to mention that Insulin is another category of medication that can cause hypoglycemia.
04:20
Taking too much or patients intentionally abusing the medication can suffer profound hyperglycemia.
Okay, it's really hard to talk
to you at the straight face.
04:32
When I'm looking at that
picture of the liver.
04:35
That is hilarious. I love that.
04:38
So think of this when you're
thinking about alcohol
and the function of your liver,
because as you know, alcohol
impairs the function of your liver,
but I want to talk about it
specifically with low blood sugar.
04:51
Now, the liver may not be able
to release enough glycogen
if you're tying it up
with metabolizing alcohol.
04:58
So if the client
is drinking alcohol
and their blood
sugar drops too low
their liver may not
be able to respond.
05:06
So there's an increased risk
of really severe hypoglycemia
if someone is drinking alcohol,
which is why I was forced
feeding french fries
to that just graduated
celebratory student.