Drug-induced Hypoglycemia (Nursing)

by Rhonda Lawes, PhD, RN

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    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.

    About the Lecture

    The lecture Drug-induced Hypoglycemia (Nursing) by Rhonda Lawes, PhD, RN is from the course Diabetes Type 1 and 2: Complications and Symptoms (Nursing).

    Included Quiz Questions

    1. Reduced glycogen breakdown
    2. Increased sympathetic activity
    3. Increased heart-rate
    4. Increased epinephrine production
    1. Glyburide
    2. Cardiovascular disease
    3. Metabolic syndrome
    4. Older adult client
    5. Kidney disease
    1. The liver may not release enough stored glycogen while metabolizing alcohol
    2. Alcohol is low in carbohydrates and most clients do not eat enough when drinking
    3. Alcohol causes vomiting which leads to hypoglycemia
    4. The liver will release too much insulin when metabolizing alcohol

    Author of lecture Drug-induced Hypoglycemia (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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