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Endoc -test2
| Question | Answer |
|---|---|
| Endocrine System Major Organs 1 | Pituitary Gland – “Master Gland” Pancreas – Exocrine & Endocrine Exocrine – enzymes for digestion Endocrine – Insulin & Glucagon |
| Endocrine System Major Organs 2 | Thyroid Gland – Thyroxine; Calcitonin Parathyroid Gland – Parathormone Adrenals Cortex – Mineralcorticoids Glucorticoids Medulla – Epinepherine Gonads – Male & Female Sex Hormones |
| Pancreas | Major Hormones of the Pancreas Glucagon Insulin Major Site of Hormone Production Islets of Langerham Glucagon – Alpha Cells Insulin – Beta Cells |
| Pancreas Normal Function | Normal Function Glucagon – Increases blood glucose levels Insulin – Decreases blood glucose levels |
| Pancreas Dysfunction | Dysfunction Glucagon – Hyposecreation = Hypoglycemia Insulin – Hyposecreation = Diabetes Mellitus; Ketoacidosis Hypersecreation = Hypoglycemia; Insulin Shock |
| Antidiabetic Medications Insulin | Anabolic hormone that functions in different ways: (1) facilitates glucose entry into muscle and fat cells (2) helps convert glucose into glycogen; amino acids into protein; free fatty acids into triglyceride |
| General Information: Insulin Pharmacokinetics (ADME) | Well distributed throughout body tissues; metabolized by the liver; excreted by the kidneys NOTE: Oral insulin does NOT exist due to poor absorption by the GI tract |
| General Information: Insulin Pharmacodynamics (Actions/Effects) | anabolic hormone that promotes storage of glucose as glycogen; increases protein and fat synthesis; inhibits breakdown of glycogen, protein & fat; decreases blood glucose level |
| General Information (con’t) Pharmacotherapeutics (Clinical Indication) | Prescribed for Type I Diabetes Melitus; gestational diabetes; juvenile diabetes May also be used for Type II during illness or severe stress; patients receiving TPN therapy |
| General Information (con’t) Drug Interactions/Adverse Effects) | alcohol; anabolic steroids; salicylates; MAO inhibitors; corticosteroids; thiazide diuretics; beta blockers Hypoglycemia (low blood sugar) |
| General Information: Insulin Pharmacokinetics (ADME) | Well distributed throughout body tissues; metabolized by the liver; excreted via the kidneys NOTE: Oral Insulin does not exist due to poor absorption by the GI tract |
| General Information: Insulin Pharmacodynamics (Actions/Effects) | anabolic hormone that promotes storage of glucose as glycogen; increases protein and fat synthesis; inhibits breakdown of glycogen, protein & fat; decreases blood glucose level |
| General Information: Insulin Pharmacotherapeutics (Clinical Indication) | Indicated for Type I diabetes mellitus; gestational diabetes, juvenile diabetes May also be used for Type II during illness or severe stress or for patients receiving TPN therapy due to a high glucose concentration in solution |
| General Information: Insulin Drug Interactions | alcohol, anabolic steroids, salicylates, MAO inhibitors, corticosteroids, thiazide diuretics, beta blockers |
| General Information: Insulin Toxicology (Adverse Effects) | Hypoglycemia (low blood sugar) Lipodystrophy (disturbance in fat metabolism) Resistance to insulin (rare) |
| General Information: Insulin Nursing Considerations 1 | Avoid dosage errors by matching dosage of bottle with correct insulin syringe (U-100/ml with U-100 insulin syringe) Do not shake rapid acting (clear) insulin; gently agitate cloudy insulin to avoid bubbles |
| General Information: Insulin Nursing Considerations 2 | Mix insulin's in the same order every time Do not substitute Mixture Insulin (70/30) for orders of Regular and NPH insulin |
| General Information: Insulin Nursing Considerations 3 | Rotate and document injection sites Preferred site: abdomen Alternative site: SQ aspect of upper arms; anterior aspect of thighs Observe for S/S of hypoglycemia during peak time of action |
| General Information: Insulin Nursing Considerations 4 | Observe for S/S of hyperglycemia which may suggest need to change dosage Polyuria, Polydipsia, Polyphagia, Weight Loss, Fatigue Teach patient how to monitor blood glucose levels (HGMS) and to administer insulin correctly |
| Oral Hypoglycemic Agents Pharmacotherapeutics 1 | All oral hypoglycemic agents, approved for use in the US are sulfonylurea They are created in generations; 1st and 2nd and are used for the treatment of Type II Diabetes Mellitus |
| Oral Hypoglycemic Agents Pharmacotherapeutics 2 | They are designed to lower blood glucose by stimulating secretion of endogenous insulin from the pancreas; reducing glucose output from the liver; enhancing peripheral sensitivity to insulin |
| Oral Hypoglycemic Agents | 1st Generation chlorpropamide (Diabinase) tolbutamide (Orinase) 2nd Generation glyburide (DiaBeta) glipizide (Glucotrol) Alpha-glucosidase Inhibitors acarbose (Precose) |
| Oral Hypoglycemic Agents Pharmacokinetics | Available only in oral form, they are absorbed well by all body tissue; metabolized by the liver and excreted by the kidney Onset of action is specific to the agent; usually reach peak action within 2 – 6 hours; duration is specific to agent |
| Oral Hypoglycemic Agents Pharmacodynamics | Produce pancreatic and extrapancreatic actions that help regulate glucose levels Usually given to patient’s who are controlled with diet and exercise |
| Oral Hypoglycemic Agents Drug Interactions/Adverse Effects | alcohol, dicumerol, anabolic steroids, MAO inhibitors, salicylates, sulfonamides, rifampin, sympathomimetic agents, thiazide diuretics, beta blockers, some antibiotics |
| Hypoglycemia | (too little food or too much medication); GI reactions; skin reactions; allergic reactions Most Severe: hematological reactions, including agranulocytosis, hemolytic anemia, and thrombocytopenia |
| Oral Hypoglycemic Agents Nursing Implications 1 | Monitor patients for adverse reactions, especially hypoglycemia and blood dyscrasias Avoid delays in mealtimes to prevent glucose alterations Keep a source of glucose readily available |
| Oral Hypoglycemic Agents Nursing Implications 2 | Give oral agents 30 minutes before meals; maintain on a regular schedule Teach patient / family about medications, drug interactions and adverse effects that need to be reported to physician |
| Glucose-Elevating Drugs | Drugs used for the emergency treatment of severe Hypoglycemia (usually < 50) Glucagon,Diazoxide,50% Dextrose Blood glucose levels begin to increase within 5 – 20 minutes of glucagon administration Adverse reactions: Mostly GI disturbances |
Created by:
d4w751
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