Drug Study Generic Name Nateglinide Brand Name Starlix Dosage 120 mg PO tid taken 1-30 min before

meals Indications Adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus whose hyperglycemia cannot be managed by diet and exercise alone. Combination therapy with metformin or a thiazolidinedione for glycemic control in those patients with type 2 diabetes who do not receive adequate control with diet and either drug. Monotherapy as an adjunct to exercise and diet to improve Contraindications Hypersensitivity to the drug, diabetic ketoacidosis, type 1 diabetes, pregnancy and lactation. Side Effects Headache, paresthesias, dizziness, hypoglycaemia (low risk), nausea, diarrhea, constipation, vomiting dyspepsia, URI, sinusitis, rhinitis and bronchitis. Nursing Responsibility Monitor urine or serum glucose levels and HBA1c levels frequently to determine effectiveness of drug and dosage being used. Administer drug three times a day 1-30 min before meals; if a patient skips or adds a meal, the dosage should be skipped or added appropriately. Arrange for consult with dietitian and thorough diabetic teaching program. Monitor baseline LFTs before beginning therapy and

Pioglitazone

Actos

15-30 mg daily as a single oral dose

Allergy to any thiazolidinedione, type 1 diabetes, ketoacidosis, New

Headache, pain, myalgia, fluid retention, HF, hypoglycaemia,

glucose control in patients with type 2 diabetes. As part of combination with sulfonylurea, metformin or insulin when diet, exercise plus a single agent alone does not result in adequate glycemic control in type 2 diabetes. Pramlintide acetate Symlin Type 1 diabetes: Initially 15 mcg by subcutaneous injection immediately before major meals. Adjunct treatment in patients with type 1 diabetes who use meal time insulin and who have failed to achieve desired glucose control despite optimal insulin therapy. Adjunct therapy in type 2 diabetes patients who use meal time insulin and who have failed to achieve desired glucose control despite

York Heart Association Class III or IV HF, lactation

hyperglycemia, aggravated diabetes, diarrhea, liver injury, sinusitis, URI, rhinitis, infection, fatigue and tooth disorders.

Hypersensitivity to pramlintide or any of its components, gastroparesis, hypoglycaemia unawareness.

Dizziness, headache, fatigue, nausea, anorexia, vomiting, abdominal pain, cough, pharyngitis and hypoglycaemia.

periodically during therapy. Monitor urine or blood glucose levels to determine effectiveness of drug and dosage being used. Arrange for consult with dietitian and thorough diabetic teaching program be aware that severe hypoglycaemia has been associated with combined used of insulin, pramlintide monitoring accordingly. Monitor serum glucose levels and HBA1c levels frequently to evaluate effectiveness of drug on controlling

optimal insulin therapy with or without a concurrent sulfonylurea or metformin.

Repaglinide

Prandin

0.5-4mg PO taken tid or qid 15-30 min before meals

Adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus whose hyperglycemia cannot be managed by diet and exercise alone. Combination therapy with metformin or thiazolidinediones to lower blood glucose in patients whose hyperlycemia cannot be controlled on diet

Hypersensitivity to the drug, diabetic ketoacidosis, & type 1 diabetes.

Headache, paresthesias, hypoglycaemia, diarrhea, constipation, vomiting, dyspepsia, URI, sinusitis, rhinitis and bronchitis.

glucose levels. Do not combine in syringe with insulin. Maintain other antidiabetic drugs, diet and exercise regimen for control of diabetes. Administer drug before meals; if a patient skips or adds a meal, the dosage should be skipped or added appropriately. Monitor urine or serum glucose levels frequently to determine effectiveness of drug and dosage being used. Arrange for consult with dietitian and thorough diabetic teaching

Rosiglitazone maleate

Avandia

4 mg as single oral dose or divided into 2 doses

and exercise plus monotherapyy with any of the following agents alone: Metformin, sulfonylureas, or thiazolidinediones. Monotherapy as an adjunct to diet and exercise to improve glucose control in patients with type 2 diabetes. As part of combination with metformin or sulfonylurea when diet, exercise, and either agent alone do not result in adequate glycemic control in type 2 diabetes.

program.

Allergy to any thiazolidinedione, type 1 diabetes, ketoacidosis, New York heart association Class III or Iv Hf, lactation.

Headache, pain, HF, hypoglycemia, hyperlycemia, diarrhea, liver injury, sinusitis, URI, dyspnea, rhinitis, infections, fatigue, accidental injury and edema.

Saxaglipitin

Onglyza

2.5-5 mg/ day PO without regards to meals

As an adjunct to diet and exercise to improve glycemic control

History of serious hypersensitivity reactions to saxaglipiitin

Headache, dizziness, abdominal pain, gastroenteritis,

Monitor baseline LFTs before beginning therapy and periodically during therapy. Monitor serum glucose levels frequently to determine effectiveness of drug and dosage being used. Administer without regard to meals. Arrange for consult with dietitian and thorough diabetic teaching program. Monitor blood glucose and HBA1c levels before and

in adults with type 2 diabetes.

vomiting, UTI, URI, nasopharyngitis and hypoglycemia.

Sitagliptin phosphate

Januvia

100 mg/ day as monotherapy or combined with metformin, pioglitazone, rosiglitazone or other drugs.

Adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus, as monotherapy or with oral antidiabetics.

History of serious hypersensitivity reactions to sitagliptin.

Headache, nasopharyngitis, URIs, and hypoglycaemia.

periodically during therapy. Monitor renal function test before and periodically during therapy. Ensure that a patient continues diet and exercise program management o type 2 diabetes. Arrange for thorough diabetic teaching program. Monitor blood glucose levels and HBA1c before and periodically during therapy. Ensure that a patient continues diet and exercise program management o type 2 diabetes. Monitor renal function test before and periodically

during therapy. Arrange for thorough diabetic teaching program.