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WVC Endo meds
WVC endo meds thyroid & diabetes drugs
| Question | Answer |
|---|---|
| metformin (Glucophage, Fortamet, Riomet): Biguanides (PO antihyperglycemic) | prevents liver from releasing excesses glucose SE= diarrhea, n&v, anorexia, hypo-glycemia, LACTIC ACIDOSIS…Take w/ meals; D/C before taking contrast dye. |
| glipzide (Glucotrol): sulfonylureas (PO antidiabetics) | stimulates release of insulin & increases insulin sensitivity SE= dizziness, HA; constipation, cramps , diarrhea, N&V, hypoglycemia; APLASTIC ANEMIA, agranulocytosis…Monitor for hypoglycemia & CBC for agranulocytosis |
| glyburide (Diabeta, Micronase, Glynase): ): sulfonylureas (PO antidiabetics) | stimulates release of insulin & increases insulin sensitivity SE= SE= dizziness, HA; constipation, cramps , diarrhea, N&V, hypoglycemia; APLASTIC ANEMIA, agranulocytosis…Monitor for hypoglycemia & CBC for agranulocytosis |
| acarbose (Precose): alpha glucosidase inhibitors(PO antidiabetic) | Delays and reduces glucose absorption SE= abdominal pain, diarrhea, flatulence…Take with meals |
| sitagliptin (Januvia): enzyme inhibitors (PO antidiabetic) | increased levels of active incretin hormones. SE= headache. PANCREATITIS, nausea, diarrhea.URI…. Monitor for hypoglycemia if used with sulfonylurea. DO NOT USE WITH TYPE 1 DIABETES. Monitor for kidney function |
| Glucagon: pancreatics (IM, I, Sub Q: hormones) | Stimulates hepatic production of glucose from glycogen breaks down stored glycogen to glucose, resulting in elevated blood glucose levels…SE= N&V…. Assess for N/V after dose. Turn on side to avoid aspiration. Large does may enhance effect of warfarin |
| Insulin aspart (NovoLog) | Rapid acting insulin ONSET:15 min PEAK: 60-90 min DURATION: 3-4 hr |
| Insulin glulisine (Apidra) | Rapid acting insulin ONSET: 15 min PEAK: 60min- 90min DURATION: 3-4 hr |
| Human lispro injection (Humalog) | Rapid acting insulin ONSET: 15 min PEAK: 60 min-90 min DURATION: 5 |
| Regular human insulin injection (Humulin R, Novolin R, ReliOn R) | Short acting insulin ONSET: 30 min- 60 min PEAK: 2-3 hrs DURATION: 3-6 hrs |
| Humulin R (Humulin R U 500) | Short acting insulin ONSET: 30min- 60 min PEAK: 2-3 hrs DURATION: 24 hrs |
| Isophane Insulin NPH Injection (Humulin N, Novolin N, ReliOn N) | Intermediate acting insulin ONSET: 2-4 Hr. PEAK: 4-10 hrs. DURATION: 18-24 + hrs |
| Insulin detemir injection (Levemir) | intermediate acting insulin ONSET: 2-4 hr PEAK: 4-10 hr DURATION: 18-2424 |
| 70% human insulin isophan suspension/ 30% human insulin injection (Humulin 70/30; Novolin 70/30; ReliOn 70/30) | intermediate acting insulin ONSET: 30 min PEAK: 2-12 DURATION: 24 |
| 50% human insulin isophan suspension/ 50% human insulin injection (Humulin 50/50) | intermediate acting insulin ONSET: 30 min PEAK: 3-5 hrs DURATION: 24 hrs |
| 70 % insulin aspart protamine suspension/ 30% insulin aspart injection (NovoLog Mix 70/30) | intermediate acting insulin ONSET: 30 min PEAK: 1-4 hrs DURATION: 24 |
| 75% insulin lispro protamine suspension/ 25% insulin lispro injection (Humalog Mix 75/25) | Intermediate acting insulin ONSET: 30 min PEAK: 1-2 hrs DURATION: 24 hrs |
| Insulin glargine injection (Lantus) | Lonf acting insulin ONSET: 2-4 hrs PEAK: none DURATION: 24 hrs |
| exenatide (Byetta): incretrin mimetic agents ( Sub Q antidiabetics) | mimics action of incretin(promotes insulin secretion) used w/ metformin (Glucophage) SE=dizziness, HA, PANCREATITIS, diarrhea, N&V, GI reflux, ↓ appetite, weight loss… Take 60 min before easting. Observe for Hypoglycemia. |
| pramlintide (Symlin):Hormone( SubQ antidiabetic) | slowed gastric emptying, suppression of glucagon secretion and regulation of food intake SE= dizziness, fatigue, HA,cough, N&V, abdominal pain, anorexia, HYPOGLYCEMIA…WATCH FOR DOSING ERRORS.. Take before a meal with at least 30g carbs |
| levothyroxine (T4, Levo-T, Levothroid, Levoxyl): thyroid preparations (PO/IV hormones) | Replacement of or supplementation to endogenous thyroid hormones SE= Nervousness, -Tremor, Tachycardia, Palpations, Insomnia.. Monitor thyroid function during therapy. Monitor TSH levels, assess for tachyarrythmias; *Monitor for s/s hyperthyroidism |
| liothyronine (T3, Cytomel): thyroid preparations ( PO/IV hormones) | Replacement of or supplementation to endogenous thyroid hormones SE= Nervousness, -Tremor, Tachycardia, Palpations, Insomnia.. Monitor thyroid function during therapy. Monitor TSH levels, assess for tachyarrythmias; *Monitor for s/s hyperthyroidism |
| liotrix (T3& T4,Thyrolar): thyroid preparations (PO hormones) | Replacement of or supplementation to endogenous thyroid hormones SE= Nervousness, -Tremor, Tachycardia, Palpations, Insomnia.. Monitor thyroid function during therapy. Monitor TSH levels, assess for tachyarrythmias; *Monitor for s/s hyperthyroidism |
| Iodine (Thyrsafe, Thyrosheid): iodine containing agents (PO antithyroid agent) | Rapidly inhibits release & synthesis of thyroid horm. SE=confusion, weakness. GI BLEEDING, diarrhea, N&V, hypothyroidism, goiter, hyperkalemia, tingling, joint pain… Assess for hypothyroidism *Assess for s/s of iodism ( |
| propylthiuracil (PTU): (PO Antithyroid agent) | Inhibits the synthesis of thyroid hormones SE= drowsiness, HA, vertigo, HEPATOTOXICITY, N&V, diarrhea, loss of taste, rash, hypothyroidism, AGRANULOCYTOSIS …Assess for hypothyroidism or hyperthyroidism; Assess for rash; assess CBC for agranulocytosis. |
| Glucagon cascade | Glucagon acts on the liver to breakdown glycogen into glucose |
| Normal glucose | 70-99 |
| Pre diabetes | 100-125 on 3 consecutive checks |
| Normal HbA1c | < 6.0 |
| Fasting Plasma Glucose diagnosis for DM | (FBS) x 3 >126 |
| Oral Glucose Tolerance Test (OGTT) results | @ 2hrs 140-199 (pre-diabetic) @2hrs >200 (diabetes) |
| OGTT for Pre-diabetes diagnosis | @ 2hrs 140-199 (pre-diabetic) |
| OGTT for diabetes diagnosis | @2hrs >200 (diabetes) |
| BUN | 7-21 (dehydration) |
| High BP= | 130/80 or greater |
| At what glucose level would you expect a client to exhibit s/s of hypoglycemia? | 60 or below (depends on the patient) |
| creatinine | 0.5-1.2 (renal function) |
| Serum TSH Levels | 0.4-4.2 |
| Free T-4 | 0.8-2.8 |
| Free T-3 | 260-480 |
| PTH | 10-65 |
| Ca level | 9.0-10.5 (10.2) |
| Phosphorous | 3.0 -4.5 |
| OGTT @ 30 minute sample: | Less than 200 mg/dL @ 30 min |
| normal HbA1c | normal A1c: 4.0-5.9% |
| Calcitonin Male: | Less than 19 pg/mL |
| Calcitonin Female: | Less than 14 pg/mL |
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