Nursing Teaching on Side Effects of Avandia Use

 Nurse educated the patient and caregiver on side effects of Avandia use as follows:

1. GI disturbance: Patients taking avandia can sometimes present with symptoms of stomach upset and gastrointestinal disturbances, such as, nausea and vomiting. Taking the medication with a glass of water and some food or snack can help avoid/reduce these unpleasant gastrointestinal symptoms.
2. Hypoglycemia: Avandia acts by reducing insulin resistance and increasing the sensitivity of body cells to insulin. Improved/reduced insulin resistance by Avandia can contribute to increased response to insulin with improved shifting of glucose from the blood into the cells of body tissues. This results in improved blood sugar control and reduced blood sugars. Extreme lowering of blood sugars and hypoglycemia with avandia alone is not a common complaint, unless it is used in combination with other medications, which have a significant risk for side effect of hypoglycemia, such as, Glimepiride and Glyburide. Patients in hypoglycemia can have poor glucose supply to the brain, which is its major source of nutrition. So, poor nutrition supply to brain cells result in severe dizziness, lightheadedness, inability to focus, irritability, headache, and weakness. Avoid skipping meals while taking avandia. Observing compliance with timely nutrition intake and recommended calorie consumption can help prevent development of hypoglycemic episodes.
3. Fluid retention: Use of avandia can contribute to significant fluid retention in the body. Retained fluid can add extra load on the heart in individuals with congestive heart failure and can lead to worsening of heart failure symptoms and cardiac function. Patients can present with edema, sharp weight gain, progressively increasing shortness of breath, compromised endurance, and worsening fatigue.
4. Liver disease: Use of avandia can result in liver disease and toxicity. Individuals with liver disease can present with abdominal discomfort, stomach pain, poor appetite, and uncontrolled nausea & vomiting. This can result in reduced intake and weight loss. Liver disease can also contribute to high bilirubin levels in the blood, which can lead to itching and irritation of skin, and yellowing of skin & eyes. High bilirubin levels in the blood can also lead to increased bilirubin elimination in urine, resulting in dark yellow urine. So, avandia could either be avoided for a safer alternative or used with extra caution maintaining close watch for development of toxic symptoms, in individuals with history of liver dysfunction. Discuss with your physician regarding history of compromised liver function, if any, and your safety with avandia intake. While on avandia, periodical labs for liver function could be ordered and individuals monitored for development of any toxic symptoms. Report to your physician for further management measures, in the event of presentation with any of the symptoms discussed above.
5. Cold or flu-like symptoms: Avandia use, by some unknown mechanisms, can contribute to cold or flu-like symptoms. Individuals can present with runny nose, sneezing, and dry cough, but these symptoms are usually self-limited. Report to your doctor for further recommendations in the event of these symptoms continuing unabated.
6. Bladder cancer: Use of Avandia is associated with increased risk for bladder cancer in some individuals. Individuals with other risk factors for bladder cancer, such as, smoking and chronic industrial chemical exposures, must be increasingly cautious with use of avandia, as the risk factors could complement each other. Individuals taking avandia must be aware of symptoms to be watchful for. Report any symptoms of bladder cancer, such as, blood in the urine, increased lower abdominal pain, increased urge to urinate, and increased urination frequency to your physician for further investigation.
7. Muscle pain: Avandia, by some unknown mechanisms, can increase risk for damage to the muscle, resulting in some muscle pain and fatigue. While taking avandia, report to your physician for further recommendations, in the event of presentation with any worsening muscle pain and increasing fatigue.