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DM2 Meglitinides - Repaglinide (Prandin) Cheat Sheet by

Treats type 2 diabetes mellitus

Mediation Name

Repagl­inide
Prandin

Therap­eutic Use

Type 2 diabetes mellitus

Adverse Drug Reactions

Hypogl­ycemia
Nausea, Vomiting

Nursing Interv­entions

Monitor for signs of hypogl­ycemia (diaph­oresis, tachyc­ardia, fatigue, excessive hunger, tremors).
If the client is conscious, give glucose orally in either pill form, glass of orange juice, 2–3 tsp of sugar, honey, or corn syrup dissolved in water.
If the client is not conscious, give intrav­enous glucose; give parenteral glucagon if IV not available
Check the client’s blood glucose every 15–20 minutes.
Continue treatment until the blood glucose has returned to the expect- ed reference range and the client is no longer sympto­matic.
Monitor for persistent nausea, vomiting, or diarrhea.
Monitor CBC levels

Drug Admini­str­ation

Give orally 30 min or less before meals, usually three times a day
Tell clients to skip a dose if they skip a meal and to add a dose if they add a meal.
Do not exceed 4 doses a day.
 

Patient Education

Wear a medical alert bracelet.
Watch for and report symptoms of hypogl­ycemia.
Test blood glucose to confirm.
If hypogl­ycemia occurs, advise patient to take a glass of orange juice or 2–3 tsp of sugar, honey, or corn syrup dissolved in water (glucose, not table sugar, if taking miglitol), and notify health care profes­sional.
Retest in 15 to 20 min and repeat treatment if still low.
Carry a carboh­ydrate snack at all times.
Lie down when feeling nauseated.
Consume adequate carboh­ydr­ates.

Contra­ind­ica­tions

Diabetic ketoac­idosis
Liver, kidney, and endocrine disorders

Precau­tions

Renal or hepatic dysfun­ction
Systemic infection
Older adults
Use of alcohol, NSAIDs, warfarin, loop diuretics, and anabolic steroids

Intera­ctions

Gemfib­rozil (Lopid), erythr­omycin, and chlora­mph­enicol increase hypo- glycemic effects.
Alcohol, cortic­ost­eroids, and rifampin decrease hypogl­ycemic effects.
 

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