NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

glipizide Glucotrol XL Antidiabetics, 5 mg PO daily
sulfonylureas
Peak Onset Duration Normal dosage range
1-2 hr 15-30 min up to 24 hr 5 mg/day initially, increased as needed (range 2.5-40
mg/day); XL dosage form is given once daily. Doses >15
mg/day may be given as 2 divided doses of regular-release
product (not XL). (Geriatric Patients ): 2.5 mg/day
initially.
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Diabetes mellitus solutions
N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(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.
Contraindications/warnings/interactions
Hypersensitivity. Hypersensitivity to sulfonamides (cross-
sensitivity may occur). Insulin-dependent diabetics.
Diabetic coma or ketoacidosis. Severe renal, hepatic,
thyroid, or other endocrine disease. Uncontrolled
infection, serious burns, or trauma. Use cautiously in:
Severe cardiovascular or hepatic disease. Geriatric patients
(increased sensitivity; dosage reduction may be required).
Severe renal disease (increased risk of hypoglycemia).
Infection, stress, or changes in diet may alter requirements
for control of blood sugar. Impaired thyroid, pituitary, or
adrenal function. Malnutrition, high fever, prolonged
nausea, or vomiting.
Common side effects
Photosensitivity, hypoglycemia, APLASTIC ANEMIA
Interactions with other patient drugs, OTC or Lab value alterations caused by medicine
herbal medicines (ask patient specifically) Monitor serum glucose and glycosylated hemoglobin
periodically during therapy to evaluate effectiveness of
E treatment. Monitor CBC periodically during therapy.
f Report ↓ in blood counts promptly. May cause an ↑ in
f AST, LDH, BUN, and serum creatinine.
e Be sure to teach the patient the following about this
c medication
t Instruct patient to take medication at same time each day.
i Take missed doses as soon as remembered unless almost
v time for next dose. Do not take if unable to eat. Explain to
e patient that this medication controls hyperglycemia but
n does not cure diabetes. Therapy is long term. Review signs
e of hypoglycemia and hyperglycemia with patient. If
s hypoglycemia occurs, advise patient to drink a glass of
s orange juice or ingest 2-3 tsp of sugar, honey, or corn syrup
dissolved in water or an appropriate number of glucose
m tablets and notify health care professional. Encourage
a patient to follow prescribed diet, medication, and exercise
y regimen to prevent hypoglycemic or hyperglycemic
episodes. Instruct patient in proper testing of serum
b glucose and ketones. These tests should be closely
e monitored during periods of stress or illness and health
care professional notified if significant changes occur.
↓ May occasionally cause dizziness or drowsiness. Caution
patient to avoid driving or other activities requiring
b alertness until response to medication is known.
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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.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Control of blood glucose
Overdose is manifested by symptoms levels without the
of hypoglycemia. Mild hypoglycemia appearance of hypoglycemic
may be treated with administration of or hyperglycemic episodes.
oral glucose. Treat severe
hypoglycemia 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. Signs and
symptoms of allergy to sulfonylureas.