Clinical Medications Worksheets

Generic Name Glyburide Trade Name Micronase Classification Antidiabetics Dose 5mg Route PO Time/frequency Q day Peak Onset Duration 1.5-3 hr 45-60 24hr Why is your patient getting this medication Gestational DM Mechanism of action and indications (Why med ordered) Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites. May also decrease hepatic glucose production. Normal dosage range 2.5-5 mg once daily initially (range 1.25-20 mg/day) For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, hypersensitivity to sulfonamides, uncontrolled infection, serious burns, or trauma. Use cautiously in pregnancy or lactation (safety not established; insulin recommended during pregnancy) Common side effects Photosensitivity, hypoglycemia, APLASTIC ANEMIA

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) None known for this patient

Nursing Process- Assessment (Pre-administration assessment) Observe for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety). Patients on concurrent beta-blocker therapy may have very subtle signs and symptoms of hypoglycemia. Assess patient for allergy to sulfonamides.

Lab value alterations caused by medicine Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness. Monitor CBC periodically during therapy. Report ↓ in blood counts promptly. May cause an ↑ in AST, LDH, BUN, and serum creatinine. Be sure to teach the patient the following about this medication Instruct patient to take medication at same time each day. Take missed doses as soon as remembered unless almost time for next dose. Do not take if unable to eat. Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to drink a glass of orange juice or ingest 2-3 tsp of sugar, honey, or corn syrup dissolved in water or an appropriate number of glucose tablets and notify health care professional. May occasionally cause dizziness or drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known. Insulin is the recommended method of controlling blood sugar during pregnancy. Counsel female patients to use a form of contraception other than oral contraceptives and to notify health care professional promptly if pregnancy is planned or suspected. Advise patient to carry a form of sugar (sugar packets, candy) and identification describing disease process and medication regimen at all times. Advise patient to notify health care professional promptly if unusual weight gain, swelling of ankles, drowsiness, shortness of breath, muscle cramps, weakness, sore throat, rash, or unusual bleeding or bruising occurs. Assessment Evaluation Why would you hold or not give this med? Check after giving Overdose is manifested by symptoms of Blood glucose level maintained hypoglycemia. Mild hypoglycemia may be WNL treated with administration of oral glucose. Severe hypoglycemia should be treated with IV D50W followed by continuous IV infusion of more dilute dextrose solution at a rate sufficient to keep serum glucose at approximately 100 mg/dl