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Pharmacology
Diabetic medications
| Question | Answer |
|---|---|
| What is Type I Diabetes? | Juvenile Diabetes |
| What are the 3 Ps of Type I Diabetes? | Polyuria, Plyphagia, Polydispia |
| What does IDDM mean? | insulin dependent diabetes mellitus |
| Is Type I diabetes adult onset or inherited? | Inherited |
| Type I diabetes is caused by? | autoimmune destruction of pancreatic beta cells |
| Is Type II diabetes insulin dependent? | No |
| What are the risk factors of Type II diabetes? | obesity, sedimentary lifestyle, age |
| Normal Blood Glucose Level | 70-100 |
| Hyperglycemia level | >140 |
| hypoglycemia level | <60 |
| Normal Hemoglobin A1C level | 5.7 |
| Pre-diabetic A1C level | 5.7-6.4 |
| Diabetic Level | above 6.5 |
| What is the action/use of insulin? | restores ability of cells to use glucose as an energy source correct hypoglycemia, used to treat type 1&2 diabetes, diabetic ketoacidosis, lowers plasma potassium levels when used in the treatment of hyperkalemia (regular) |
| Lantus and Regular insulin are compatible. | False, they are incompatible |
| when should glucose levels be checked more often? | if patient is on steroid because of potential increased glucose |
| What are the signs/symptoms of hypoglycemia? | headache, confused, dizzy, sweating, shaky, hungry, grumpy |
| When do you give Glucan or Dextrose? | when blood glucose is less than 45 |
| What are non-sulfonylureas? | Biguanides lower blood glucose by decreasing production of glucose by the liver |
| Common Medications of non-sulfonylureas | Prandin (no grapefruit) Glucophage (metformin, given with food) |
| Contraindications of non-sulfonylureas | kidney disease can't take, not used with diabetic ketoacidosis (DKA) |
| non- sulfonylureas administration considerations | monitor CBC, glucose, A1c, liver function test monitor compliance |
| what are the side effects of non-sulfonylureas | lactic acid build up in the bloodstream |
| how do you draw up insulin | long to fast, put air in the fast, put air in the short, draw up short, draw up fast |
| Can insulin be given subcutaneous and intramuscular? | insulin can be given subcutaneous only |
| Can all insulins be given IV? | only regular insulin can be given by IV |
| What are the injection sites to give insulin | upper arms, thighs, abdomen, scapular area |
| What are the uses and actions of Sulfonylureas? | Stimulate release of insulin form pancreatic islets and increase sensitivity of insulin receptors on cells |
| What are the common medications for Sulfonylureas? | Glucotrol (glipizide) anticoagulant in hypoglycemia Glynase |
| What are the administration consideration when giving Sulfonylureas? | dose is given orally 1-3 times a day, DM type II insulin is started sulfonylureas are stopped , allergies to sulfa or urea can not take, advanced chronic kidney disease would have to take metformin |
| What is Diabetic Ketoacidosis? | serious condition with uncontrolled diabetes with increased blood glucose level but no insulin available |
| Does diabetic ketoacidosis happen slowly? | No, happens suddenly |
| Treatment for diabetic ketoacidosis is: | IVF normal saline, electrolyte replacement |
| What can cause you to have Fruity breath? | Diabetic Ketoacidosis |
| What are the causes of Hyperosmolar Hyperglycemic State? | cells not receptive to insulin, illness, infection (all happens gradually) |
| Treatment for Hyperosmolar Hyperglycemic State is: | IVF- isotonic fluids (na+, H20); decreased blood glucose |
| What is Hyperosmolar Hyperglycemic State: | life threatening, triggered by illness of infection, not following diabetic plan, no ketones, glucose greater than 600, blood too concentrated to draw water from |
| What are the types of insulin? | lispo (clear), aspart (cloudy), regular (clear, only one that can be given by IV), NPH (Isophane) cloudy, Lantus (does not peak, given at night), NPH/Regular (cloudy) |
| What are Aminoglycosides used for? | to treat gram negative pathogens; resistant to drugs and antibiotics |
| What are examples of Aminoglycosides? | Amikacin, Gentamicin, Streptomycin, Tobramycin (only on e that has a peaking through) |
| What are the indications of Aminoglycosides? | Used to treat many serous aerobic gram-negative infections Used primarily when penicillin drugs have not worked or are contraindicated used for serious infections such as sepsis and meningitis |
| What is the adverse reaction to Aminoglycosides? | Muscle Paralysis |
| What are the associated labs with Aminoglycosides? | Renal function (BUN, Cr) when given IV, LFT (liver function test) Culture and sensitivity prior to beginning therapy when given IV Peak (highest range normal 5.0-10) and trough (lowest range 1.0-2) |
| What are the nursing considerations to Aminoglycosides? | ototoxic-hearing loss temporary or permanent, often not reversible; Nephrotoxic- reduced kidney function, usually reversible; can lead to cirrhosis when used long term; monitor for C-diff |
| What is a Superinfection? | infection during or immediately after an existing infection, means the normal flora is disturbed, common in thrush, vaginal yeast, diarrhea (C-diff) |
| What is the patient education for Aminoglycosides? | drink plenty of fluids to decrease accumulation of medication in the kidneys |
| What antibiotic is most effective against gram positive? | Penicillin |
| What are examples of Penicillins? | Amoxicillin, Augmentin, Pipercillin, Trimoix, Unasyn |
| What are the adverse reactions to Penicillin? | Angioedema (swollen lips and tongue), Steven Johnson Syndrome, Erythematous (red blisters, decrease BP, complaining of throbbing joints), skin rash, Urticaria (hives) Pruritus (itching) |
| what are the associated labs with Penicillin? | may elevate LFT (ALT, AST) when given IV (test for liver function) |
| What are the nursing considerations for Penicillin? | do not give with acidic fruit juice as it destroys penicillin |
| Patient education for Penicillin is? | may decrease effectiveness of birth control pills (use second method of birth control) |
| Are Cephalosporins safe to use in pregnancy? | Yes, safe to use in pregnancy, if allergic to penicillin don't use |
| What are examples of Cephalosporins? | First generation: most gram-positive coverage: Anecef, Keflex Third generation: Cefobid, Cefzil, Claforan, Fotaz, Rocephin |
| What are the adverse reactions of Cephalosporins? | C-diff, Pain at IM site, phlebitis at IV sit, Steven Johnson Syndrome |
| What are the associated labs with Cephalosporins? | renal function (BUN, Cr) when given IV |
| What are the nursing considerations with Cephalosporins? | monitor for cross reaction in patients who have an allergy to penicillin |
| What is the patient education for Cephalosporins? | avoid alcohol and OTC cough preparations to avoid Antabuse like reactions (flushing face, headache, nausea, vomiting, blurred vision, chest pain, weakness, anxiety) |
| What are drugs that fight infection? | Lactams/Carbapenems |
| What are examples of Lactams/Carbapenems? | Primaxin, Azactam |
| What are the adverse reactions of Lactams/Carbapenems? | nausea, vomiting, diarrhea, GI symptoms: cause super infection, seizures (medications given only IV or IM) |
| What are the associated labs of Lactams/Carbapenems? | decrease valproic acid levels: seizure levels decrease and high risk for seizures; may decrease hemoglobin and hematocrit levels |
| Nursing considerations for Lactams/Carbapenems are? | use cautiously in those with sensitivity to penicillin and cephalosporin (do not give); small risk of drug induced seizure activity |
| What are Fluoroquinolones/Quinolones drugs? | these drugs inhibit intracellular enzymes essential for duplication, transcription, repair of bacteria DNA |
| What are examples of Fluoroquinolones/Quinolone drugs? | Cipro (ciprofloxan) Levaquin ( levaquifolaxin) |
| What are Fluoroquinolone/Quinolone indications? | used to treat Redman's Syndrome (comes form IV; signs/symptoms-red rash upper torso, rash is flat not raised, spread to face and arms |
| what are the adverse reactions to Fluoroquinolone/Quinolone drugs? | Diarrhea C-diff, Stevens Johnson Syndrome, Tendon rupture |
| What Syndrome has red blisters? | Stevens Johnson Syndrome |
| What Syndrome has a red rash upper torso, rash is flat, not raised, that spread to face and arms and comes from an IV? | Redman's Syndrome |
| Associated labs with Fluoroquinolones, Quinolone drugs? | may decrease glucose levels |
| Nursing considerations for Fluoroquinolones/Quinolone drugs? | drink plenty of fluids when taking these medications to prevent crystalluria (cloudy urine that consist of crystals) can affect Vitamin K syntheses (clotting factor) |
Created by:
Valadiece
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