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Nursing Knowledge
Biguanides can be used as monotherapy or in combination. They may be used in gestational diabetes. Clients instructed not to drink alcohol and educated about signs of lactic acidosis. Stop medication prior to tests with iodine contrast.
Metformin
2nd-generation sulfonylureas can be used as monotherapy or with metformin.
Meglitinides can be used as monotherapy or with metformin. They are shorter-acting than sulfonylureas and are taken with each meal. The client must eat within 30 minutes after taking the medication.
Thiazolidinediones can be used as monotherapy or with metformin or sulfonylureas. Clients with heart failure must be monitored closely.
Alpha-glucosidase inhibitors can be used as monotherapy or with insulin or sulfonylureas. There is no risk of low blood sugar when used alone.
DPP-4 inhibitors can be used as monotherapy or in combination. Clients need teaching on the signs of pancreatitis.
Dopamine agonists can be used as monotherapy or in combination. Marketed under a different name for Parkinson and hyperprolactinemia.
Bromocriptine
SGLT-2 inhibitors can be used as monotherapy or in combination. There is ongoing research for use with Type 1 diabetes.
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Table: Oral diabetes medication classes and nursing teachings
| Medication class | Teaching |
| Biguanides | Biguanides can be used as monotherapy or in combination. They may be used in gestational diabetes. Clients must not not drink alcohol and be educated about signs of lactic acidosis. Stop medication prior to tests with iodine contrast. |
| 2nd-generation sulfonylureas | 2nd-generation sulfonylureas can be used as monotherapy or with metformin. |
| Meglitinides (glinides) | Meglitinides can be used as monotherapy or with metformin. They are shorter-acting than sulfonylureas and are taken with each meal. The client must eat within 30 minutes after taking the medication. |
| Thiazolidinediones (glitazones) | Thiazolidinediones can be used as monotherapy or with metformin or sulfonylureas. Clients with heart failure must be monitored closely. |
| Alpha-glucosidase inhibitors | Alpha-glucosidase inhibitors can be used as monotherapy or with insulin or sulfonylureas. There is no risk of low blood sugar when used alone. |
| DPP-4 inhibitors (gliptins) | DPP-4 inhibitors can be used as monotherapy or in combination. Clients need education on signs of pancreatitis. |
| Dopamine antagonists | Dopamine agonists can be used as monotherapy or in combination. Marketed under a different name for Parkinson and hyperprolactinemia. |
| Sodium-glucose co-transporter-2 inhibitors | SGLT-2 inhibitors can be used as monotherapy or in combination. There is ongoing research for use with Type 1 diabetes. |
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