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Chap - 23
PharmacologyHSC1149
| Question | Answer |
|---|---|
| all insulins are U-100 meaning there are 100 __ of insulin in __ 1 mL. | units; each |
| Lispro insulin (Humalog) is one of the __ __ insulins | rapid acting |
| aspart (Novolog) is | rapid acting insulin |
| insulin onset 15 min; peak 30min-1hr; duration 3h | rapid acting |
| insulin onset 30min-1h; peak 2-5h; duration 5-8h | short acting |
| regular insulin still acts __ __ | very fast |
| regular insulin is usually ordered for __ __ doses | sliding scale |
| regular insulin is usually ordered based on __ __ levels | blood glucose |
| brand of regular insulin, which is also manufactured by other companies with different brand names such as Novolin R | Humulin R |
| insulin onset 1-2.5h; peak 6-12h; duration 16-24h | intermediate acting |
| only intermediate insulin used now is | NPH insulin |
| Lente insulin has been | discontinued |
| brand name for NPH insulin | NovonlinN or HumulinN |
| insulin onset 2h; peak 10-18h or no peak; duration >24h | long acting |
| many patients w/diabetes that has stabilized are using newer __ acting insulins. | long |
| brand name for long acting insulin that has been discontinued | Ultralente |
| an advantage of glargine (Lantus) is that the insulin does not have a __ so there is a more steady level of insulin in the body | peak |
| long acting insulin | detemir (Levemir) |
| sometimes __ __ of insulin will be mixed in one syringe prior to injection | two types |
| some patients are able to use a __ __ preparation made by the manufacturer | combination insulin |
| mixture of insulin is 50% NPH insulin and 50% regular insulin | Humulin 50/50 |
| insulin is 70% NPH insulin and 30% regular insulin | Novolin 70/30 |
| are to be used for the measurement and administration of U-100 insulin only | insulin syringes |
| insulin syringes must not be used to measure other medications that are measured in | units |
| standard U-100 insulin syringe; one side of the insulin syringe calibrated in odd-number two-unit increments and the other side calibrated in even-number two-unit increments | 100 units insulin syringe |
| Lo-Dose U-100 insulin syringe; calibrated for each 1 unit; measures up to 50 units per 0.5 mL | 50 unit insulin syringe |
| Lo-Dose U-100 insulin syringe; measures up to 30 units per 0.3 mL | 30 unit insulin syringe |
| specific techniques to measure an accurate dose and the regular insulin; __ is always drawn up first | clear |
| before mixing two insulins together, the __ of the two medications must be verified | compatibility |
| for __ __ storage, insulin may be kept at room temperature | short term |
| HumaPen LUXURA HD | Insulin Pen |
| HumaPen LUXURA HD is made for use with __ 3mL cartridges | Humalog |
| HumaPen MEMOIR | Insulin Pen w/memory |
| MiniMed 508 | simple insulin pump |
| MiniLink transmitter is used with an insulin pump to | monitor glucose |
| wireless insulin pump w/remote | OmniPod |
| increase insulin production from the pancreas and improve peripheral insulin activity | sulfonylureas |
| delay digestion of complex carbohydrates and subsequent absorption of glucose | alpha-glucosidase inhibitors |
| decrease hepatic glucose output and enhance insulin sensitivity in muscle | Biguanides |
| stimulate beta cells of the pancreas to produce insulin | meglitinides |
| decrease insulin resistance and improve sensitivity to insulin in muscle | thiazolidinediones |
| rosiglitazone (Avandia), | thiazolidinedione |
| repaglinide (Prandin) & Nateglinide (Starlix) | meglitinide |
| metformin (Glucophage) | Biguanides |
| acarbose (Precose) | alpha-glucosidase inhibitor |
| glyburide (DiaBeta), chlorpropamide (Diabinese), & glipizide (Glucotrol) | sulfonylurea |
| refers to internal secretion (hormone) produced by a ductless gland secreting directly into the bloodstream | endocrine |
| endocrine system drugs include natural hormone secreted by the ductless glands or __ __ | synthetic substitutes |
| located at base of brain; regulates function of other glands; called master gland | pituitary gland |
| somatropin, adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), & gonadotropic hormones (FSH, LH, & LTH) are the four hormones | secreted by pituitary gland |
| somatotropin, called human growth hormone (HGH), is secreted by the __ lobe of the pituitary | anterior |
| HGH regulates __ | growth |
| growth abnormalities, treated by only endocrinologists, are a result of __ production of HGH | insufficient |
| ACTH is available only for __ use as corticotropin | parenteral |
| synthetic peptide of ACTH & used mainly for diagnosis of adrenocortical insufficiency | cosyntropin (Cortrosyn) |
| treatment for pituitary associated disorders is usually reserved for the __, in which dosage is more easily regulated & available in __ form as well | corticosteroids; oral |
| located adjacent to kidneys; secrete corticosteroids, which act on immune systems to suppress body's response to infection or trauma | adrenal glands |
| relieve inflammation, reduce swelling & suppress symptoms in acute conditions | corticosteroids |
| corticosteroids are used as __ therapy when pituitary/adrenal gland secretions are deficient | replacement |
| corticosteroids are used for their anti-inflammatory & __ properties | immunosuppressant |
| decreasing production of antibodies & phagocytes and depressing inflammatory reaction | immunosuppressive |
| corticosteroid therapy is not __ | curative |
| corticosteroid therapy is used as __ therapy with other medications | supportive |
| reaction to insect bites, poison plants, chemicals, other meds, etc. in which there are symptoms of rash, hives, or anaphylaxis | allergic reaction |
| corticosteroid therapy is used for __ __ of rheumatic/collagen disorders when only a few inflamed joints can be injected w/corticosteroids to decrease crippling, or in life-threatening situations | acute flares-ups |
| corticosteroid therapy is used for acute flare-ups of __ __ conditions that do not respond to conservative therapy | severe skin |
| in treatment of an acute flare-up of a skin condition, __ __ of corticosteroids are preferred to systemic therapy | topical applications |
| corticosteroid therapy is used for __ __ disorders such as status asthmaticus and sarcoidosis | acute respiratory |
| corticosteroid therapy for status asthmaticus is preferred as __ __ | oral inhalations |
| corticosteroid therapy can be used to prevent __ __ disease in prematures | hyaline membrane |
| corticosteroid therapy, in treatment of hyaline membrane disease, is administered __ to mother at least __ before delivery | IM; 24h |
| when corticosteroid therapy is used in treatment of malignancies, other neoplastic drugs are used as part of the __ regime | chemotherapy |
| in treatment of leukemia, lymphoma, & Hodgkin's disease the corticosteroid used is | prednisone |
| used for treatment of nausea & vomiting associated w/chemotherapy | dexamethasone |
| corticosteroid therapy is used in treatment of __ __ associated with a brain tumor or neurosurgery | cerebral edema |
| in organ transplants, corticosteroid therapy is used w/other immunosuppressive drugs to prevent __ of transplanted organs | rejection |
| corticosteroid therapy is used in treatment of __ __ due to adrenocortical insufficiency | life-threatening shock |
| corticosteroid therapy used in treatment of shock, other than due to adrenocortical insufficiency, is considered | controversial |
| corticosteroid therapy used in treatment of acute flare-ups of __ __ should only be used short-term to avoid hemorrhage | ulcerative colitis |
| suppression of pituitary w/adrenal atrophy, body no longer produces its own hormone, can be caused by __ __ of corticosteroids | prolonged administration |
| to minimize the effects of corticosteroids, when prolonged use is necessary, they are given by __ __ | alternate-day therapy |
| withdrawal of corticosteroids, after prolonged use, should always be gradual via __ dosage | tapering |
| can lead to acute adrenal insufficiency, shock, & even death | corticosteroid abrupt withdrawal |
| in order to reduce systemic effects corticosteroids are administered for short-periods and __ if possible | locally |
| oral corticosteroids are available in dose packs to facilitate dose tapering when used for | acute episodes |
| when used for long periods corticosteroids can delay wound healing and increase susceptibility to | infections |
| osteoporosis w/fractures, especially in older women , can result from __ use of corticosteroids | long-term |
| children on long-term use of corticosteroids can experiencing stunting in growth, which is caused when there is | premature closure of bone ends |
| long-term use of corticosteroids can lead to __ disorders, incl. cushingoid state, amenorrhea, & hyperglycemia | endocrine |
| petechiae, __ __, skin thinning & tearing can be caused by long-term use of corticosteroids | easy bruising |
| corticosteroids should be used in only __ __ along w/appropriate anti-infectives when patient has viral or bacteria infections | life-threatening situations |
| corticosteroids should only be used during __ __ if specific therapy is concurrent | fungal infections |
| corticosteroids cause __ __ for patients with hypothyroidism & cirrhosis | exaggerated responses |
| corticosteroids are __ for patient w/hypertension or CHF | contraindicated |
| in patients with diabetes corticosteroids __ hyperglycemia | increase |
| for patients with glaucoma corticosteroids may increase __ __ | intraocular pressure |
| corticosteroids may precipitate __ in patient with history of gastric/esophageal irritation | ulcers |
| corticosteroids are contraindication for patients with __ disorders or seizures | thromboembolic |
| when taking corticosteroids with barbiturates, phenytoin, & rifampin dosage __ required | adjustment |
| estrogen & oral contraceptives may __ corticosteroids | potentiate |
| NSAIDs used w/corticosteroids, aspirin may increase risk of __ __ | GI ulceration |
| interaction when diuretics, which potentiate __ depletion, are administered w/corticosteroids which also result in __ loss | potassium |
| pituitary drug; IM, subQ repository gel for injection; trade name for corticotropin (ACTH) | HP Acthar |
| pituitary drug; IM, IV, subQ for adrenocortical insufficiency; trade name for cosyntropin | Cortrosyn |
| adrenal corticosteroid; PO, IM for replacement therapy; trade name for cortisone | Cortone |
| adrenal corticosteroid; PO, IN, IM, inhalation; trade name for dexamethasone | Decadron |
| adrenal corticosteroid; PO, for orthostatic hypotension; trade name for fludrocortisone | Florinef |
| adrenal corticosteroid; PO, IV, deep IM, SubQ intraarticular; trade name for hydrocortisone | Cortef, Solu-Cortef |
| adrenal corticosteroid; PO, IV, deep IM, intraarticular; trade name for methlyprednisone | Depo-Medrol, Medrol, Solu-Medrol |
| adrenal corticosteroid; PO tab or sol; do not confuse w/prednisolone; trade name for prednisone | Deltasone, Sterapred |
| adrenal corticosteroid; PO, IM; trade name for triamcinolone | Aristocort, Kenalog |
| thyroid preparations are used in __ __ for hypothyroidism caused by diminished/absent thyroid function | replacement therapy |
| generally preferred because their hormonal content is standardized & effects are predictable | synthetic thyroid agents |
| congenital; requires immediate treatment to prevent mental retardation | cretinism |
| endocrine condition(s) due to simple goiter | myxedema & adult hypothyroidism |
| causes slowed metabolism w/symptoms ranging from fatigue, dry skin, weight gain, sensitivity to cold, irregular menses, & mental deterioration if left untreated | hypothyroidism |
| hypothyroidism is diagnosed by __ __ before medication is given | blood test |
| with a patient is euthyroid the use of thyroid agents in __ __ is contraindicated, ineffective, & dangerous; leads to decrease in normal thyroid function & possible cardiac arrhythmias | weight reduction |
| __ hypothyroidism is rare | transient |
| thyroid replacement therapy must be __ __ __ | continued for life |
| monitoring thyroid drug therapy for __ __ and periodic lab tests are recommended | toxic effect |
| when receiving orders for levothyroxine, caution is advised about __ __ placement | decimal point |
| when receiving orders for levothyroxine, caution is advised about dose conversions between __ & __ as medication errors have occurred | mg; mcg |
| toxic effects are the result of __ of thyroid & are manifested in the signs of __ | overdosage; hyperthyroidism |
| palpitations, tachycardia, cardiac arrhythmias, >BP, nervousness, tremor, headache, insomnia, weight loss, diarrhea, abdominal cramps, intolerance to heat, fever, excessive sweating, & menstrual irregularities are signs of __ __ or __ | toxic effects; hyperthyroidism |
| thyroid replacement therapy is contraindicated, or advised to use w/extreme caution, for patients w/ cardiovascular disease incl. angina pectoris MI & __ | hypertension |
| thyroid replacement therapy is contraindicated, or advised to use w/extreme caution, for older patients because it may precipitate __ cardiac pathology | dormant |
| thyroid replacement therapy is contraindicated, or advised to use w/extreme caution, for patients w/ adrenal insufficiency because __ required first | corticosteroids |
| thyroid replacement therapy is contraindicated, or advised to use w/extreme caution, for patients w/diabetes because close monitoring of __ __ is required | blood glucose |
| thyroid replacement therapy may cause potentiation of oral anticoagulant effects if added after __ therapy stabilizes | warfarin |
| thyroid replacement therapy interaction with insulin & oral hypoglycemics & __ __ necessary | dosage adjustment |
| thyroid replacement therapy interaction with __ decreases response of thyroid medications | soy |
| patients being treated w/thyroid meds should not change the __ or to a __ without physician approval | brand; generic |
| used to relieve symptoms of hyperthyroidism in prep for surgical or radioactive iodine therapy | antithyroid agents |
| side effects of __ __rare & may include rash uticaria, pruritus, blood dyscrasias (especially agranulocytosis) | antithyroid agents |
| __ or __ w/antithyroid agents applies to prolonged therapy, patients >40yr, pregnant/lactating, & hepatic disorders | contraindications; caution |
| antithyroid agent interactions w/other drugs causing __ are potentiated | agranulocytosis |
| patients being treated w/antithyroid agents should notify the physician immediately of signs of illness, incl. chills, fever, rash, sore throat, malaise, & __ | jaundice |
| thyroid agent; 25-200mcg daily; levothyroxine trade name is | Synthroid, Levothroid, Levoxyl |
| thyroid agent; 60-180mcg daily; thryoid trade name | Armour Thyroid |
| antithyroid agent; tabs 5-30mg daily, divided doses; methimazole trade name is | Tapazole |
| antithyroid agent; tabs 100-150mg daily, divided doses; propylthiouracil trade name is | PTU |
| antithyroid agent; tabs 130mg daily for treatment of radiation emergencies; potassium iodide trade name is | Iostat. Thyro-Block |
| administered to lower glucose levels in those w/impaired metabolism of carbohydrates, fats & proteins | antidiabetic agents |
| classified as insulin dependent type1 or non-insulin dependent type2 | diabetes mellitus |
| formerly described as maturity-onset diabetes because it was usually found in adults >40yr; insufficient production of insulin from islets of Langerhans in pancreas | Type1 |
| increase in children & young adults due to obesity at earlier age | Type2 |
| type2 patient who fail to maintain satisfactory blood glucose levels w/diet & oral antidiabetic agents require | insulin replacement therapy |
| insulin indicated for __ __ at time of surgery, fever, severe trauma, infections, serious renal/hepatic dysfunction, endocrine dysfunction, gangrene, or pregnancy | stable type2 |
| regular insulin is used in the ER treatment of diabetic __ or __ | ketoacidosis; coma |
| insulin must be administered __ because it is destroyed in __ __ | parenterally; GI tract |
| inhaled form of insulin; became avail. mis-2006 | Exubera |
| Exubera is contraindicated for smokers & those with COPD/asthma because of | respiratory side effects |
| all __ __ products are pork, beef-pork, biosynthetic human, or analog | injected insulin |
| capable of causing antigenic reactions, and rarely used today | pork & beef-pork insulins |
| biosynthetic insulins are referred to as "human" because their __ __ structure is identical to naturally occurring human insulin | amino acid |
| differs from human insulin only by substitution or position changes in the human insulin molecule, which mimics normal insulin secretion better than traditional insulins | analog insulins |
| biosynthetic & analog insulins are created using __ __ technology | recombinant DNA |
| __ __ differ mainly on their onset, peak, & duration of action | insulin preparations |
| rapid acting & have very short duration of action; clear; onset approx. 15 min, peak 1/2 to 1h & last approx. 3h; only subQ | Aspart & lispro |
| rapid acting and of short duration; only type to be administered intravenously & subcutaneously | regular insulin |
| all insulins, other than regular insulin can only be given | subQ |
| regular insulin is sometimes __ __ isophane/zinc insulin in same syringe | combined with |
| when two insulins are ordered at same time the regular insulin should be drawn into the syringe | first |
| combinations of NPH & regular insulin; rapid onset w/duration up to 24h | Humulin 70/30, Novolin 70/30, Reg. Iletin II |
| not compatible with any other of the types of insulins | insulin glargine |
| blood is tested for glucose & specific amount of regular insulin is administered subQ based on glucose level shown by test | sliding scale administration |
| Aspart trade name | Novolog |
| Lispro trade name | Humalog |
| intermediate; onset 1-2.5h, peak 6-12h, duration 16-24h; Isophane (NPH) trade name | Humulin N., Novolin N., NPH Iletin II |
| intermediate; onset 1-2.5h, peak 6-12h, duration 16-24h; Lente trade name | Humulin L., Novolin L., Lente Iletin II |
| long; onset 2h, no peak, duration>24h; Glargine trade name | Lantus |
| long; onset 2h, no peak, duration>24h; Ultralente trade name | Humulin U |
| mixture; peak 7-12h, duration 16-24h; NPH/Reg 70/30 or 50/50; trade name | Humulin/Novolin |
| mixture; peak 7-12h, onset 5min, duration 1-24h; NPL/Lispro trade name | Humalog Mix 75/25 |
| open vials may be stored at __ __ without loss of potency for one month | room temperature |
| anterior lobe hormone ___ is called the human growth hormone | somatotropin |
| antithyroid agents are used to relieve symptoms of __ in prep for surgical or radioactive iodine therapy | hyperthyroidism |
| in 911 treatment of diabetic ketoacidosis/come, __ __ is administered IV | regular insulin |
| osteoporosis, gastric irritation/ulceration, endocrine disorders, increased susceptibility to infection, fluid & electrolyte imbalance are __ __ __ of corticosteroid use | potential side effects |
| alpha-glucosidase inhibitors, i.e. acarbose (Precose), delay digestion of complex carbs & absorption of glucose, resulting in a(n) __ rise in blood glucose following meals | smaller |
| when instructing patients about insulin injections, they should be encouraged to __ injection sites | rotate |
| most insulin in use today is U-100, which means there are 100 units of insulin per | milliliter |
| major side effects of sulfonylureas include gastrointestinal distress, weakness & fatigue, and | hypoglycemia |
| initial treat of hypoglycemia in a patient who is conscious is 4oz of __ __, candy, honey, or syrup | orange juice |
| because of increase in obesity, more children & young adults are developing __ __ | Type2 diabetes |
| only type to be administered IV & subQ is | regular insulin |
| endocrine system drugs include natural hormones or __ __ | synthetic substitutes |
| stimulate beta cells of pancreas to produce insulin | repaglinide (Prandin) |
| insulin overdose, insufficient food intake, excessive exercise, & change in type of insulin are conditions that lead to | development of hypoglycemia |
| initial treatment of hypoglycemia in a patient who is __ includes:administering either 50% glucose IV or glucagon IV/IM | unconscious |
| when patient is diagnosed w/hypothyroidism the preferred thyroid replacement therapy includes | synthetic agents, i.e. levothyroxine |
| lower blood glucose by decreasing insulin resistance/improving sensitivity to insulin in muscle & adipose tissues | thiazolidinediones |
| metformin (Glucophage) can be used as __ monotherapy or in combination w/sulfonylureas | initial |
| when preparing insulin administration it is essential that someone else compare dosage is syringe with dosage ordered to | prevent errors |
| a patient who develops an allergic reaction to poison ivy, __ corticosteroid therapy is indicated | local |
| decrease hepatic glucose output & enhance insulin sensitivity in muscle | biguanides |
| contraindicated in older adult patients and those w/cardiovascular disease, adrenal insufficiency & diabetes | thyroid replacement therapy |
| patient w/Type2 diabetes, who requires oral antidiabetic meds, should take the medication in a single dose __ __ or 2divided doses, __ morning & evening meals | before breakfast; before |
| the most common oral hypoglycemic drugs are classified as | sulfonylureas |
| if a patient's blood glucose is >350 | call physician for dosage |
| if a patient's blood glucose is 301-350 | administer 12 units of regular insulin |
| if a patient's blood glucose is 251-300 | administer 8 units of regular insulin |
| if a patient's blood glucose is 200-250 | administer 5units of regular insulin |
| if a patient's blood glucose is <200 | administer no insulin |
| undiagnosed diabetes, insulin dose insufficient, infections, surgical/other trauma, emotional distress, other endocrine disorders, & pregnancy can result in | hyperglycemia |
| dehydration & excessive thirst, anorexia & unexplained weight loss in adults <40yr, polyuria, fruity breath, lethargy, weakness, flu symptoms, & coma (if untreated), vision problems & ketoacidosis are all | symptoms of hyperglycemia |
| includes IV fluids to correct electrolyte imbalance & regular insulin added to IV fluids are | treatment of acute hyperglycemia |
| insulin is antagonized by corticosteroids or __, necessitating __insulin dosage | epinephrine; increased |
| oral contraceptives & estrogen may also __ insulin requirements | increase |
| Propranolol w/insulin poses risk of | hypoglycemia or hyperglycemia |
| when taken w/insulin: alcohol, MAOIs, salicylates, or anabolic steroids have __ of hypoglycemic effect | potentiation |
| increased perspiration, irritability, confusion/bizarre behavior tremor, weakness, headache/tingling of fingers, blurred/double vision, loss of consciousness & convulsions, in older diabetics may mimic CVA are all | symptoms of hypoglycemia |
| excessive amounts of sugar or frequent overdoses of insulin may result in __ hyperglycemia from accelerated release of glucagon | rebound |
| rebound hyperglycemia | Somogyi effect |
| involves reduction of insulin dosage w/continuous monitoring of blood glucose | treatment for Somogyi effect |
| oral diabetic agents are not a substitute for | dietary management |
| principal therapy for management of Type2 diabetes is | weight reduction & modified diet |
| excessive weight gain after 40yr, polydipsia, polyuria, excessive weakness, poor circulation/healing, visual problems are all | symptoms of Type2 diabetes |
| oral antidiabetic agents are available in several pharmacological classes with differing mechanism of action, offering different avenues for | reducing glucose levels |
| oral diabetic agents that work at different sites are often __ and some may be used in combination w/one another or w/insulin | synergistic |
| sulfonylureas are the __ hypoglycemic drugs | oral |
| __ sulfonylureas have higher potency, better tolerance, & fewer drug interactions | 2nd-generation |
| sulfonylureas work by increasing insulin production from the pancreas & by improving __insulin activity | peripheral |
| side effects from alpha-glucosidase inhibitors can include elevated __ __, which are dose-related, generally asymptomatic, & reversible | liver enzymes |
| for patients w/impaired liver/kidney function, IBD/intestinal obstruction, pregnancy/lactating, or children alpha-glucosidase inhibitors are | contraindicated or to be used with extreme caution |
| acarbose can interact w/alpha-glucosidase inhibitors because __ __ reduce the effect | digestive enzymes |
| serum digoxin concentrations should be __ when used with alpha-glucosidase inhibitors | reduced |
| estrogen & oral contraceptives can impair glucose __ when taken w/alpha-glucosidase inhibitor | tolerance |
| biguanides can produce __ __ in patients w/history of ketoacidosis, severe dehydration, cardiorespiratory insufficiency, renal dysfunction, & chronic alcoholism w/liver damage | lactic acidosis |
| hypoglycemia is a __ __ of biguanides | side effect |
| biguanides are __ for patients w/impaired liver/kidney function, CHF, pregnant/lactating, in children & elderly | contraindicated |
| biguanides w/administration of __ __ could result in acute alteration of renal function | radiocontrast dye |
| for patients taking biguanides, metformin should be __ prior to tests w/radioactive dye | withheld |
| biguanides, metformin, can cause a(n) __ __ when takes w/alcohol, calcium channel blockers, cimetidine, furosemide, digoxin, morphine, procainamide, quinidine, ranitidine, triamterene, trimethoprim, vancomycin, & amiloride | increased effect |
| metformin should be held the day of & 48h __ administration of radiopaque contrast media | after |
| repaglinide can be used as __ or in combination w/metformin | monotherapy |
| GI effects, hypoglycemia, & upper respiratory infection, sinusitis, arthralgia, & headache are all | side effects of meglitinides |
| for patient w/diabetic ketoacidosis, impaired liver function, pregnancy/lactating and use in children meglitinides are | contraindicated |
| repaglinide should be administered before meals to | maximize absorption |
| meglitinides may __ or __ effects of gemfibrozil (Lopid) | enhance; prolong |
| thiazolidinediones can be used as a monotherapy or __ with a sulfonylurea, insulin, or metformin | concomitantly |
| weight gain, fluid retention, edema, URI, sinusitis, pharyngitis, headache, myalgia, & anemia are all | side effects of thiazolidinediones |
| hypoglycemia is a side effect when thiazolidinediones are taken with insulin or | oral hypoglycemics |
| for patient w/chronic renal insufficiency, impaired liver function, CHF, pregnancy/lactating & children thiazolidinediones are | contraindicated |
| thiazolidinediones may cause resumption of __ in post-menopausal patients | ovulation |
| thiazolidinedione, pioglitazone, taken w/oral contraceptives may __ effectiveness | reduce |
| thiazolidinedione, pioglitazone, taken w/ketoconazole or itraconazole can cause potentiation of __ __ | hypoglycemic effect |
| does not inhibit any of the major cytochrome enzymes responsible for drug metabolism/drug interactions seen w/other oral antidiabetic agents | rosiglitazone |
| diabetic properly balanced diet consists of restricted calories, avoiding simple sugars, alcohol, & foods high on | Glycemic Index |
| white bread, white potatoes & white rice are | high on Glycemic Index |
| complex carbs (i.e. whole-grain breads & cereal & brown rice are | low on Glycemic Index |
| on a properly balanced diabetic diet should be low in fats, high in __, and includes adequate fluid intake | fiber |
| both types of diabetics should take oral/insulin medication at the | same time everyday |
| unopened vials of insulin should be stored at 2-8ºC and should not be subjected to | freezing |
| avoid exposure of insulin to extreme temperatures & | direct sunlight |
| if a patient increases exercise or reduces amount of food intake they should notify a physician because __ insulin may be required | less |
| 1st-generation sulfonylurea; 250-1500mg/day ac or divided; acetohexamide trade name is | Dymelor |
| 1st-generation sulfonylurea; 100-500mg/day w/meal (do not use for older adults); chlorpropamide trade name is | Diabinese |
| 1st-generation sulfonylurea; 100-1000mg/day or divided ac; tolazamide trade name is | Tolinase |
| 1st-generation sulfonylurea; 250-3000mg/day or divided; tolbutamide trade name is | Orinase |
| 2nd-generation sulfonylurea; 1-5mg/day w/meal; glimepiride trade name is | Amaryl |
| 2nd-generation sulfonylurea; 2.5-40mg/day ac or divided; glipizide trade name is | Glucotrol |
| 2nd-generation sulfonylurea; 5-20mg/day w/meal; glipizide trade name is | Glucotrol XL |
| 2nd-generation sulfonylurea; 1.25-20mg/day or divided w/meal; glyburide trade name is | DiaBeta, Micronase |
| 2nd-generation sulfonylurea; 1.5-12mg/day w/meal; glyburide trade name is | Glynase |
| alpha-glucosidase inhibitor; 25-100mg TID, w/1st bite of meal; acarbose trade name is | Precose |
| alpha-glucosidase inhibitor; 25-100mg TID, w/1st bite of meal; miglitol trade name is | Glyset |
| biguanide; 500-2,550mg/day divided w/meals; metformin trade name is | Glucophage |
| biguanide; 500-2,000mg/day divided w/meals; metformin trade name is | Glucophage XR |
| meglitinide; 60-120mg TID w/meals; nateglinide trade name is | Starlix |
| meglitinide; 0.5-4mg BID divided; repaglinide trade name is | Prandin |
| thiazolidinedione; 15-45mg/day; pioglitazone trade name is | Actos |
| thiazolidinedione; 4mg/day or BID divided; rosiglitazone trade name is | Avandia |
| combination; 1.25/250-10/2,000mg/day BID w/meals; glyburide/metformin trade name is | Glucovance |
| combination; 2/500-8/2,000mg/day w/meals or divided; rosiglitazone/metformin trade name is | Avandamet |
| in older adults, start w/the __ __ possible titrating __ to desired glycemic control | lowest dose; upward |
| to mix isophane & zinc insulin gently __; do not __ | rotate; shake |
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lfrancois
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