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GENERIC NAME: Glyburide BRAND NAME: DiaBeta, Euglucon, Glynase, Micronase CLASSIFICATION: hormone and synthetic substitute, antidiabetic agent, sulfonylurea 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO – (1.25, 2.5, 5) mg tablets; (1.5, 3, 4.5, 6) mg micronized tablets DOSING: Control Hyperglycemia – 1.25 – 5 mg/d with breakfast, may incrase by 2.5 – 5 mg q 1 – 2 wk, >15 mg/d Should be given in divided doses with morning and evening meal; micronized 1.5 – 3 mg/d 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: lowers blood sugar concentration in both diabetic and nondiabetic individuals by sensitizing functioning pancreatic beta cells to release insulin in the presence of elevated serum glucose levels. Blood glucose-lowering effect persists during long-term glyburide Tx, but there is a gradual decline in meal stimulated secretion of endogenous insulin toward pretreatment levels USES: Adjunct to diet to lower blood glucose in pts with type 2 diabetes mellitus; after dietary control alone has failed 4. Major side effects & drug interactions. DRUG INTERACTIONS: alcohol causes disulfiram-like reaction in some pts; oral anticoagulants, MAO inhibitors, salicylates, sulfonamides may potentiate hypoglycemic actions; thiazides may antagonize hypoglycemic effects. Cimetidine may increase levels. HERBAL INTERACTIONS: garlic, ginseng may increase hypoglycemic effects SIDE EFFECTS: N/V, heartburn, pruritis, erythema, blurred vision
5. Nursing Implications & teaching. IMPLICATIONS: • Monitor blood glucose levels carefully during the dangerous early Tx period when dosage is being individualiazed • First signs of hypoglycemia may be hard to recognize if pt is also receiving a beta blocker, or in older pts • Monitor at regular intervals, blood and urine glucose, HbA1c, urine ketone, and liver function test TEACHING: • Eat or drink some form of sugar when symptoms of hypoglycemia occur, • Check blood sugar more closely during periods of stress as loss of control of diabetes may result during these times • Keep all follow-up medical appointments and adhere to dietary instructions, regular exercise program, and scheduled urine and blood testing • Report blurred vision