SGLT2 Inhibitors

Endocrine & Metabolic

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Examples

empagliflozincanagliflozindapagliflozin

Prefix / Suffix: -gliflozin

Physiology

Kidneys reabsorb most filtered glucose via SGLT2 transporters. Blocking these causes glucose excretion in urine.

Mechanism of Action

Inhibit SGLT2 in proximal renal tubule, reducing glucose reabsorption and increasing urinary glucose excretion.

Indications

Type 2 diabetes
Heart failure (proven cardiovascular benefit)
Chronic kidney disease (renoprotective)

Side Effects / Adverse Effects

Genital mycotic infections (yeast — common)
UTIs
Volume depletion, hypotension
Euglycemic DKA (rare but serious)
Increased amputation risk (canagliflozin)
Fournier's gangrene (rare)

Contraindications

Severe renal impairment
Type 1 diabetes (DKA risk)
Recurrent genital infections

Nursing Considerations

Encourage adequate fluid intake (volume depletion risk)
Teach genital hygiene to reduce infection risk
Monitor BP — risk of hypotension, especially with diuretics
Hold during illness, surgery, or fasting (DKA risk)
Teach signs of DKA — even with normal glucose (euglycemic DKA)
Significant cardiovascular and renal benefits beyond glucose lowering

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.