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Blood Glucose Agents
Module 4 Drug Classifications
| Question | Answer |
|---|---|
| What is the action of insulin? | Hormone promoting the storage of the body's fuels. Facilitates the transportation of metabolites & ions across the cell membranes. Stimulates GLYCOGEN synthesis from glucose. Reacts w/specific receptor sites on the cells. |
| What are the indications for using insulin? | To be used on: Type 1 Diabetes Type 2 diabetes |
| What is Type 1 Diabetes Mellitus? | When the pancreas's beta cells are destroyed & cannot produce enough insulin. |
| What is Type 2 Diabetes Mellitus? | When patients are unable to produce enough insulin, or insulin receptors are not sensitive enough to insulin to maintain glucose control. CANNOT be controlled by diet or other agents. |
| What are the contraindications for using insulin? | No contraindications, because it is a replacement hormone. |
| What should you be cautious for prior to administering insulin? | Pregnancy & Lactation due to changes in metabolic rate. Needs to be monitored closely & adjusted frequently. |
| What are the adverse effects for insulin? | Hypoglycemia: When given an excess, glucose levels drop. Ketoacidosis: Can result when under dosing due to high blood sugar. |
| What are the drug-drug interactions for insulin? | Any drug that DECREASES GLUCOSE LEVELS= HYPOGLYCEMIA. BETA BLOCKERS (used for hypertension): can mask signs and symptoms of hypoglycemia. |
| What is hyperglycemia and the range? | Increased blood sugar. 126 mg/dl or HIGHER |
| Define glycosuria | Sugar is spilled into the urine |
| Define polyphagia | Increased hunger |
| Define Polydipsia | Increased thirst |
| Define Lipolysis | Fat breakdown |
| Define Ketosis | breakdown of fats for energy resulting in increase in ketones to be excreted in the body. Ketones cannot be removed effectively. |
| Define Acidsosis | Liver cannot remove all of the waste products |
| What is Glycosylated hemoglobin ( HbA1c)? | Blood glucose marker that provides a 3 month average of blood glucose levels. |
| What is hypoglycemia and the range? | Low blood sugar. 70 mg/dL or LOWER |
| What are the DRUGS for the drug classification SULFONYLUREAS? | Chlorpropamide, Glyburide, and Glipizide |
| What generation & drug classifcation is Chlorpropamide? | It is a first generation Sulfonylurea. It's not used often d/t increase risk of CVD & death. Only used in pts who have been on it for a long time and works for them. |
| What generation & drug classification is Glyburide and Glipizide? | These drugs are second generation Sulfonylureas, which are excreted in urine & bile. They don't interact w/ as many protein-bound drugs and have a longer action duration. |
| What are the actions of Sulfonylureas? | They stimulate insulin from the pancreas's beta cells and improve binding to insulin receptors. |
| What are the indications for Sulfonylureas? | This drug class are an adjunct to diet & exercise to lower blood glucose levels in Type 2 Diabetes. |
| What are the contraindications for Sulfonylureas? | Any known allergies. In diabetes complicated by acute illness, traumatic event, ketoacidosis, liver/kidney disease. Type 1 Diabetes: These drugs will not have an effect as beta cells are already destroyed. Not used in pregnancy d/t metabolic rate chang |
| What are the adverse effects for Sulfonylureas? | Hypoglycemia d/t imbalance levels of glucose and insulin. GI distress: N/V, epigastric discomfort, heartburn, and anorexia. Allergic skin reactions. |
| What are the drug-drug interactions for Sulfonylureas? | Any drug that acidifies the urine because excretion of sulfonylureas may be decreased. Beta Blockers: masks the sign & symptoms of hypoglycemia Alcohol affects glucose levels. |
| What are "other antidiabetic agents?" | Metformin, Sitagliptin, Dulagliptin & Liraglutide, Canagliflozin |
| What drug is an glucose elevating agent? | Glucagon |
| What is the action for glucose elevating agents? | It increases blood glucose levels by decreasing insulin release & accelerating the breakdown of glycogen in the liver to release glucose. |
| What is an indication for glucose elevating agents? | Indicated to raise glucose blood levels when severe hypoglycemia occurs ( <70 mg/dL) |
| What are the adverse effects for glucagon? | GI upset: N/V |
| What is a drug-drug interaction for glucagon? | Anticoagulants: When combined, it can increase anticoagulant effects. |
| What is the onset, peak, and duration for Regular insulin? | Onset: 30-60 min, Peak: 2-4 h, Duration: 6-12 h |
| What is the onset, peak, and duration for NPH insulin? | Onset: 1-1.5 h, Peak: 4-12 h, Duration 24 h |
| What is the onset, peak, and duration for Inhaled insulin? | Onset: 12-15 min, Peak: 60 min, Duration: 2.5-3 h |
| What is the onset, peak, and duration for Lispro insulin? | Onset: Less than 15 min, Peak: 30-90 min, Duration: 2-5 h |
| What is the onset, peak, and duration for Aspart insulin? | Onset: 10-20 min, Peak: 1-3 h, Duration: 3-5 h |
| What is the onset, peak, and duration for Glargine insulin? | Onset: 60-70 min, Peak: NONE (basal), Duration: 24 h |
| What is the onset, peak, and duration for Glulisine insulin? | Onset: 2-5 min, Peak: 30-90 min, Duration: 2 h |
| What is the onset, peak, and duration for Detemir insulin? | Onset: 1-2 h, Peak: 3-6 h, Duration: 5.7-23.3 h |
| What is the onset, peak, and duration for Combination Insulins (Humalog 50/50, Humalog 75/25, Novolog , Humulin, & Novolin 70/30) | Onset: 30-60 min then 1-2 h, Peak: 2-4 h then 6-12 h, Duration: 6-8 h then 18-24 h. |
| What are the signs & symptoms of Hyperglycemia? | Fatigue, lethargy, irritation, glycosuria, polyuria, polyphagia, polydipsia, and itchy skin |
| What are the signs of impending dangerous complications of hyperglycemia? | Fruity breath (the result of ketone build up in the system and are excreted through the lungs). Dehydration, slow & deep respirations (Kussmaul's respiration) as the body is trying to rid high acid levels, and loss of orientation & coma. |
| What disorders are associated w/ Diabetes? | Atherosclerosis, Retinopathy, Neuropathies, and Nephropathy |
| Define Atherosclerosis | Heart attacks and strokes related to the development of atherosclerotic plaques in the vessel lining |
| Define Retinopathy | With resultant loss of vision as tiny vessels in the eye are narrowed and closed |
| Define Neuropathies | With motor and sensory changes in the feet and legs and progressive changes in other nerves as the oxygen is cut off |
| Define Nephropathy | With renal dysfunction related to changes in the basement membrane of the glomerulus |
Created by:
jmajalca
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