McKenna's Pharmacology, 2e

4

P A R T 1  Introduction to nursing pharmacology

692 Hormonal drugs

Sulfonylurea: Increased risk of hypoglycae- mia. CONTRAINDICATIONS Contraindicated in individuals hypersensi- tive to the drug or any of the ingredients. CARE CONSIDERATIONS • Monitor blood glucose levels closely. • Monitor white cell counts regularly. • Whenused in conjunctionwith a sulfonyl- urea, dosage of the sulfonylurea may need reducing to avoid hypoglycaemia. PATIENT TEACHING • Advise person that drug may be taken with or without food. • Advise person to continue taking the medication even if feeling well. • Advise individual to report persistent, severe abdominal pain to doctor immedi- ately. vildagliptin Galvus Pregnancy risk category B3 Use in sport: Permitted AVAILABLE FORMS Tablets: 50 mg INDICATIONS & DOSAGES ➤ Management of type 2 diabetesmellitus in dual combination— Adults: In dual combination with metfor- min, 50 mg PO in the morning or 50 mg PO b.i.d. In dual combination with a sulfonylurea, 50 mg PO once daily in the morning. Adjust-a-dose: Avoid if creatinine clear- ance is below 50 mL/minute. Avoid in per- son with hepatic impairment. ACTION Enhances glycaemic control in type 2 dia- betes by improving beta-cell receptiveness to glucose, stimulating insulin synthesis and

sitagliptin Januvia

Pregnancy risk category B3 Use in sport: Permitted AVAILABLE FORMS Tablets: 25 mg, 50 mg, 100 mg INDICATIONS & DOSAGES

➤ Management of diabetesmellitus type 2— Adults over 18 years: 100 mg PO once daily. Adjust-a-dose: Adults with moderate

PO once daily.

ACTION Enhances glycaemic control in type 2 dia- betes by improving beta-cell receptiveness to glucose, stimulating insulin synthesis and release and lowering glucagon secretion leading to reduced production of glucose in the liver.

Route

Onset

Peak

Duration

PO

Unknown

1–4 hrs

24 hrs

ADVERSE REACTIONS CNS: headache. ENT: nasopharyngitis. GI: abdominal pain, diarrhoea, nausea, vomiting, pancreatitis. Haematological: neutrophilia. Musculoskeletal: rhabdomyolysis. Skin: generalised exfoliative dermatitis, rash, urticaria, Stevens-Johnson syndrome. Other: hypersensitivity reactions such as anaphylaxis,angio-oedema, rash, urticaria and other skin conditions. INTERACTIONS Drug-drug. Digoxin: May slightly increase plasma digoxin levels. Metabolic: hypoglycaemia. Renal: acute renal failure.

Reactions may be common , uncommon, life-threatening , or COMMONAN

REATENING.

FIGURE 1.1  Example of a drug monograph from McKenna’s Drug Handbook for Nursing and Midwifery (7th edn).

sufferers. It is only available in Australia through the Australian Government’s Special Access Scheme. Ingestion of a plant-derived food can sometimes lead to a drug effect. For instance, the body converts natural liquorice to a false aldosterone—a hormone found in the body—resulting in fluid retention and hypokalaemia or low serum potassium levels if large amounts of liquorice are eaten. However, people seldom think of liquorice as a drug. DH_7E_Ch_53.indd 692

Finally, plants have become the main component of the growing alternative therapy movement. Chapter 6 discusses the alternative therapy movement and its impact on today’s drug regimens. Animal products Animal products are used to replace human chemicals that fail to be produced because of disease or genetic problems. Until recently, insulin for treating diabetes was obtained exclusively from the pancreas of cows and 30/01/14 2:40 PM