alogliptin
alogliptin
(al-oh-glip-tin) alogliptin,Nisena
(trade name)Classification
Therapeutic: antidiabeticsPharmacologic: dipeptidyl peptidase4 ddp4 inhibitors
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (inhibition of DDP-4)
| ROUTE | ONSET | PEAK† | DURATION |
|---|---|---|---|
| PO | unknown | 1–2 hr | 24 hr |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- headache
Gastrointestinal
- hepatotoxicity (life-threatening)
- pancreatitis (life-threatening)
- ↑ liver enzymes
Miscellaneous
- hypersensitivity reactions including anaphylaxis, angioedema, severe cutaneous reactions including stevens-johnson syndrome
Interactions
Drug-Drug interaction
↑ risk of hypoglycemia with sulfonylureas and insulin, dose adjustments may be necessaryRoute/Dosage
Renal Impairment
Oral (Adults) CCr ≥30 mL/min–<60 mL/min—12.5 once daily; CCr <30 mL/min–6.25 once daily.Availability
Nursing implications
Nursing assessment
- Observe for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety).
- Monitor for signs of pancreatitis (nausea, vomiting, anorexia, persistent severe abdominal pain, sometimes radiating to the back) during therapy. If pancreatitis occurs, discontinue alogliptin and monitor serum and urine amylase, amylase/creatinine clearance ratio, electrolytes, serum calcium, glucose, and lipase.
- Assess for rash periodically during therapy. May cause Stevens-Johnson syndrome. Discontinue therapy if severe or if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis and/or eosinophilia.
- Lab Test Considerations: Monitor hemoglobin A1C prior to and periodically during therapy.
- Monitor renal function prior to and periodically during therapy.
Potential Nursing Diagnoses
Imbalanced nutrition: more than body requirements (Indications)Noncompliance (Patient/Family Teaching)
Implementation
- Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin.
- Oral: May be administered without regard to food.
Patient/Family Teaching
- Instruct patient to take alogliptin as directed. Take missed doses as soon as remembered, unless it is almost time for next dose; do not double doses. Advise patient to read Medication Guide before starting and with each Rx refill in case of changes.
- Explain to patient that alogliptin helps control hyperglycemia but does not cure diabetes. Therapy is usually long term.
- Instruct patient not to share this medication with others, even if they have the same symptoms; it may harm them.
- Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hyperglycemic or hypoglycemic episodes.
- Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to take a glass of orange juice or 2–3 tsp of sugar, honey, or corn syrup dissolved in water, and notify health care professional.
- Instruct patient in proper testing of blood glucose and urine ketones. These tests should be monitored closely during periods of stress or illness and health care professional notified if significant changes occur.
- Advise patient to stop taking alogliptin and notify health care professional promptly if symptoms of hypersensitivity reactions (rash; hives; swelling of face, lips, tongue, and throat; difficulty in breathing or swallowing) or pancreatitis occur.
- Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
- Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.
Evaluation/Desired Outcomes
- Improved hemoglobin A1C, fasting plasma glucose and 2-hr post-prandial glucose levels.