Adverse Drug ReactionsHypoglycemia | Nausea, Vomiting |
Nursing InterventionsMonitor 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 AdministrationGive 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 EducationWear 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. |
ContraindicationsDiabetic ketoacidosis | Liver, kidney, and endocrine disorders |
PrecautionsRenal or hepatic dysfunction | Systemic infection | Older adults | Use of alcohol, NSAIDs, warfarin, loop diuretics, and anabolic steroids |
InteractionsGemfibrozil (Lopid), erythromycin, and chloramphenicol increase hypo- glycemic effects. | Alcohol, corticosteroids, and rifampin decrease hypoglycemic effects. |
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