Generic NameRosiglitazone

Trade NameAvandia

ClassificationAnti diabetics

Dose4 mg

RoutePO

Time/frequencyQday, before a meal

PeakUnknown

OnsetUnknown

Duration12-24 hours

Normal dosage range4 mg as a single dose once daily or 2 mg twice daily; after 8 weeks, may be increased if necessary to 8 mg once daily or 4 mg twice daily

Why is your patient getting this medicationTx of type II Diabetes Mellitus

For IV meds, compatibility with IV drips and/or solutionsN/A

Mechanism of action and indications(Why med ordered)Improves sensitivity to insulin by acting as an agonist at receptor sites involved in insulin responsiveness and subsequent glucose production and utilization

Nursing Implications (what to focus on) Contraindications/warnings/interactionsContraindicated in cases of hypersensitivity and DKA, Use cautiously with concurrent use with insulin (may increase risk of adverse cardiovascular reactions)Common side effectsNo common side effects

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Insulin may increase risk of adverse cardiovascular reactions.

Lab value alterations caused by medicineMay cause ↓ in hemoglobin, hematocrit, and WBC, usually during the first 4-8 wk of therapy; then levels stabilize. May cause irreversible ↑ in AST and ALT or hepatic failure (rare). If ALT increases to >3 times the upper limit of normal, recheck ALT promptly. Discontinue rosiglitazone if ALT remains >3 times normal. May cause ↑ in total cholesterol, LDL, and HDL and ↓ in free fatty acids

Be sure to teach the patient the following about this medicationTake as directed. If dose is missed do not double the dose the next day.This medicine controls hyperglycemia but does not cure diabetes. 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. Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hypoglycemic or hyperglycemic episodes. Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified if significant changes occur. Advise patient to notify health care professional immediately if signs of hepatic dysfunction (nausea, vomiting, abdominal pain, fatigue, anorexia, dark urine, jaundice) or CHF occur.

Nursing Process- Assessment(Pre-administration assessment)Take FSBG. Observe patient taking concurrent insulin for signs and symptoms of hypoglycemia (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety)

AssessmentWhy would you hold or not give this med?Blood sugar less than 100

EvaluationCheck after givingWatch for signs of hypoglycemia. Check FSBS at least every 6 hours Monitor serum glucose and glycosylated hemoglobin

periodically during therapy to evaluate effectiveness