by Cathy Parkes September 06, 2021 Updated: September 09, 2021
Hi. I'm Cathy with Level Up RN. In this video, I'm going to continue my coverage of oral antidiabetic medications. I'll also be covering a medication that is used for hypoglycemia as opposed to hyperglycemia. And at the end of the video, I'm going to provide you guys a little quiz, a little knowledge check to test your understanding of some of the key concepts I'll be covering in this video. So definitely stay tuned for that.
Also, there will very likely be a blooper reel at the end of this video because pronouncing antidiabetic medications is kind of my arch-nemesis so I'm going to do my best not to butcher these names. So thank you in advance for your patience.
All right. So let's first talk about thiazolidinediones, which includes pioglitazone. So this medication class helps to decrease blood glucose levels by decreasing insulin resistance and glucose production. It also helps to increase uptake of glucose in the body's cells. Key side effects include fluid retention, elevated LDL levels, hepatotoxicity, and this drug class also has a black box warning due to the risk of congestive heart failure. So heart failure will be a key contraindication when it comes to pioglitazone. And that makes sense, right? Because with pioglitazone, we have fluid retention and with heart failure, we already likely have fluid volume overload because that heart is not pumping effectively. So if we overwhelm the heart even more with additional fluid retention, it is not going to be a good scenario for that patient.
All right. My way of remembering this drug and some of the key side effects of pioglitazone is when I look at the name pioglitazone, it kind of looks like Pig Zone. And when I think of Pig Zone, it helps me to remember fluid retention, edema, and increased LDL levels. So hopefully, my little trick here helps you to remember some of those side effects as well.
All right. Next up, we have an alpha glucose inhibitor, which is Acarbose. So this medication works to decrease blood sugar levels by inhibiting glucose absorption in the GI tract. Key side effects include GI, upset as well as hepatotoxicity. So a key contraindication of Acarbose is a GI disorder. So if a patient has a gastrointestinal disorder, then we would advise them not to take this medication because the mode of action is in the GI tract.
So the way I remember this medication, if you look at the name Acarbose, and you break it down, A means no or without, and then carbs so no carbs will be absorbed with Acarbose. And that's not fully accurate, right? We'll still absorb some carbohydrates, but it will decrease the absorption of carbohydrates which will help to control the patient's blood sugar levels. All right. So those are all of the oral antidiabetic agents that we're going to cover.
I'm now going to talk about a Glycogenolytic agent which is Glucagon. So we would use Glucagon for severe hypoglycemia in a patient who is unconscious or somehow not able to take an oral glucose. So normally, if a patient is conscious and able to safely swallow and they have hypoglycemia, we can give them 15 grams of a readily absorbable carbohydrate to help that situation. However, if the patient is unconscious or unable to swallow safely, we need to give them Glucagon, and we can give this medication through the IV, IM, or subcutaneous route. Once we administer this medication and the patient is fully conscious and able to swallow safely again, then we want to provide them food afterwards.
So the way I remember this medication is if you look at Glucagon, it helps to remind me that when the glucose is all gone, then we give them Glucagon.
All right. Time for a quiz. I have three questions for you. First question: What medication works by decreasing glucose absorption in the GI tract? The answer is Acarbose. Question number two: Which medication causes fluid retention and is contraindicated for heart failure? The answer is Pioglitazone. Question number three: What medication do you give an unconscious patient with hypoglycemia? The answer is Glucagon.
All right. I hope you all did great on that quiz. If you missed any questions, just go back and watch my video again, review the flashcards. It really takes repetition to learn all of this pharmacology information which is why flashcards work so well for this subject. So take care and good luck studying.
Blooper Reel: After you've provided them the Glucajohn-- Glucajohn, Glucajohn. Hopefully, you didn't give them any Glucajohn because that's not a thing.
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