A nurse is caring for an older adult who is diagnosed with type 2 Diabetes. The patient is pre-scribed oral medication for diabetes. The nurse can expect that which of the following medica-tions is prescribed as a first-line therapy?
a. Insulin
b. Sulfonylureas
c. Metformin
d. Chlorpropramide
ANS: C
Metformin (Glucophage) is commonly prescribed as first-line therapy; it does not cause hypogly-cemia or weight gain. Sulfonylureas were used for many years as first-line agents for all persons with type 2 DM. However, they are associated with hypoglycemia and can only be used in per-sons who can either be aware of the signs themselves or who have a caregiver capable of doing so; therefore, Metformin is considered the first line of therapy. Insulin is used for individuals with type 2 DM; however, it is not first-line therapy. Chlorpropramide is contraindicated due to a long half-life and the fact that it can cause prolonged hypoglycemia.
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