Home Drug Guide Pramlintide Acetate

Drug Guide

Generic Name

Pramlintide Acetate

Brand Names Symlin

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Amylin analog

FDA Approved Indications

Type 1 diabetes mellitus as an adjunct to insulin therapy
Type 2 diabetes mellitus as an adjunct to mealtime insulin or oral antidiabetic agents

Mechanism of Action

Pramlintide mimics the natural hormone amylin, which slows gastric emptying, suppresses glucagon secretion, and promotes satiety, thereby reducing postprandial blood glucose levels.

Dosage and Administration

Adult: Administer subcutaneously before meals, typically 15 mcg or 60 mcg per injection, titrated based on response.

Pediatric: Not indicated for pediatric use.

Geriatric: Use with caution; no specific dose adjustments established.

Renal Impairment: Use with caution; no specific dose adjustment but monitor closely.

Hepatic Impairment: No specific guidelines available.

Pharmacokinetics

Absorption: Subcutaneous absorption; rapid onset.

Distribution: Limited data available.

Metabolism: Metabolized by proteolytic enzymes.

Excretion: Excreted via renal pathways.

Half Life: Approximate half-life of around 50 minutes.

Contraindications

Gastrointestinal motility disorders (e.g., gastroparesis)
Hypoglycemia unawareness

Precautions

Use with insulin; risk of hypoglycemia increased.
Adjust insulin doses accordingly when initiating therapy.

Adverse Reactions - Common

Nausea (Common)
Headache (Common)
Injection site reactions (Common)

Adverse Reactions - Serious

Severe hypoglycemia (especially in Type 1 diabetes) (Uncommon)
Allergic reactions (rash, swelling, difficulty breathing) (Rare)

Drug-Drug Interactions

Insulin (increased hypoglycemia risk)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels closely, especially when initiating therapy.

Diagnoses:

Risk for hypoglycemia

Implementation: Administer subcutaneously, instruct patient on proper injection technique, monitor blood glucose, and adjust insulin accordingly.

Evaluation: Assess blood glucose response and tolerability to therapy.

Patient/Family Teaching

Instruct on proper administration technique.
Educate about recognizing and managing hypoglycemia.
Advise on the importance of adhering to meal timing and insulin adjustments.

Special Considerations

Black Box Warnings:

Severe hypoglycemia when used with insulin

Genetic Factors: No known genetic considerations.

Lab Test Interference: No significant interference reported.

Overdose Management

Signs/Symptoms: Severe hypoglycemia, nausea, vomiting.

Treatment: Administer glucose as needed, monitor blood glucose levels closely, and provide supportive care.

Storage and Handling

Storage: Store in a refrigerator (36°F to 46°F); can be kept at room temperature not exceeding 86°F for up to 30 days.

Stability: Stable under recommended storage conditions.