alogliptin

(redirected from Nisena)

alogliptin

(al-oh-glip-tin) ,

Nisena

(trade name)

Classification

Therapeutic: antidiabetics
Pharmacologic: dipeptidyl peptidase4 ddp4 inhibitors
Pregnancy Category: B

Indications

Adjunct with diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Action

Acts as a competitive inhibitor of dipeptidyl peptidase-4 (DDP-4) which slows the inactivation of incretin hormones, thereby increasing their concentrations and reducing fasting and postprandial glucose concentrations.

Therapeutic effects

Improved control of blood glucose.

Pharmacokinetics

Absorption: Completely absorbed following oral administration (100%).
Distribution: Well distributed into tissues.
Metabolism and Excretion: Not extensively metabolized, 76% excreted unchanged in urine.
Half-life: 21 hr.

Time/action profile (inhibition of DDP-4)

ROUTEONSETPEAK†DURATION
POunknown1–2 hr24 hr
†Multiple dosing.

Contraindications/Precautions

Contraindicated in: Type 1 diabetes;Diabetic ketoacidosis;Previous severe hypersensitivity reactions.
Use Cautiously in: Liver disease; Geriatric: Elderly patients may have ↑ sensitivity to effects; Lactation: Use cautiously; Obstetric: Use during pregnancy only if clearly needed; Pediatric: Safe and effective use has not been established.

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 necessary

Route/Dosage

Oral (Adults) 25 mg once daily.

Renal Impairment

Oral (Adults) CCr ≥30 mL/min–<60 mL/min—12.5 once daily; CCr <30 mL/min–6.25 once daily.

Availability

Tablets: 6.25 mg, 12.5 mg, 25 mg
In combination with: metformin (Kazano), pioglitazone (Oseni).

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.
Mentioned in ?
References in periodicals archive ?
(50) Comenta Mateo-Seco: "Al considerar la cristologia nisena, en el campo de la union hipostatica, es necesario prestar atencion, sobre todo, mas que a la terminologia usada, a la exactitud con que realiza la comunicacion de idiomas" (Mateo-Seco, "Notas sobre el lenguaje cristologico de Gregorio de Nisa," 91).
En este articulo se estudia la comprension nisena de la mediacion de Cristo a partir del analisis de algunos de sus textos.
(31) La nocion nisena de la apatheia se halla purificada de cualquier vision negativa: es la sublimacion del pathos sensible por el pathos espiritual; se trata mas bien de la serenidad propia del hombre virtuoso y sabio.
My parents Francisco Roces and Nisena Ortiz had me, their first daughter and second child of seven, christened Maria Isabel, the Spanish version of Elizabeth, little knowing they may have inadvertently set me off on a long, arduous journey to what seemed, until now, my elusive, personal happiness.
La doctrina nisena sobre la perfeccion del ser divino sustentada en la fe bautismal le permite defender con solidos argumentos filosoficos la trinidad de Dios y la divinidad del Espiritu Santo como nadie en el siglo IV consiguio hacer.
El texto clave en la comprension nisena de la encarnacion es el de Jn 1,14: "el Verbo se hizo carne".
Siempre dentro de un alto nivel, es precisamente en las paginas dedicadas a la teologia nisena de la procesion del Espiritu Santo donde este libro alcanza especiales cotas (pp.
El uso de los diferentes terminos que hace Gregorio para referirse de modo distinto a la generacion del Hijo y a la procesion del Espiritu Santo, y su particular hincapie en el titulo de Unigenito del Hijo (63), que manifiesta la absoluta exclusividad de la relacion Padre-Hijo (64), ponen de manifiesto que no se ha de leer el <<[TEXTO IRREPRODUCIBLE EN ASCII]>> unilateralmente como expresion unica de la comprension nisena de la distincion entre el Hijo y el Espiritu.
El texto nos interesa por la puntualizacion nisena: el hombre ve en si mismo la belleza divina.
Pero junto a eso, y ademas de la publicacion de una monografia fundamental para la comprension de la cristologia nisena: Estudios sobre la cristologia de San Gregorio de Nisa (1978), ha escrito numerosos articulos en los que analiza practicamente todos los ambitos de la obra de este Padre de la Iglesia.
Aquel trabajo influyo hondamente en mis investigaciones, en particular porque ponia en evidencia la relevancia de la definicion nisena de la tercera Persona de la Santisima Trinidad como vinculo de la unidad ([TEXTO IRREPRODUCIBLE EN ASCII.]) (2).