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IOS 9 Exam 3
Inhalation of systemic Pharmaceuticals
| Question | Answer |
|---|---|
| Inhaled insulins | Exubera, Aradigm, Alkermes, Mannking technosphere, Kos Breath actuated |
| Byetta dosing | Before morning & even meal 5mcg BID months then 10mg BID (weight loss) - consider decreaseing dose if used with sulfonylureas (50% or D/C sulfa) |
| Sitagliptin dosing | 100mg Qd if ClCr30-50 50mg QD, or >30mg QD 25mg |
| Sitagliptin cautions | Pregnancy B, P-glycoprotein substratit, No P40 effects |
| Pramlintide dosing | Must eat 30g CHO, can use in Type 1= 50% of mealtime insulin 15ug per meal max 60ug Type 2 -60ug up to 120ug |
| Pramlintide SE | weight loss, nausea, anorexia |
| Self-monitoring glucose Type 1 | BID insulins 2x day MDI= 3-4 times occassionaly at 1-3am |
| Type 2 glucose monitoring | Insulin- like Type 1 (2x day for BID or 3-4 if rapid acting) ORAL- controlled 3x week, uncontrolled 1x day, med change consider daily |
| Treatment of hypoglycemia | <70mg/dL 4-5 lifesavers, 4glucose tabs, recheck in 15-20 minutes and eat something CHO/Fat/Protein |
| Treatment of hypoglycemia unconscious | Glucagon SQ , IM, IV > 20kg =1mg must add diluent , reconstitute then inject |
| Dawn phenomenon is | Excessive response to growth hormone in the early am (47am), causes relative resistance to insulin, elevated FPG in am, will need to change Basal by increasing |
| Somogyi effect is | Nocturnal hypoglycemia causes release of glucagon, cortisol, growth hormone which results in hyperglycemia. Pt will pee in bed or hungery in am- treat-Increase protein content of HS snack and/or decrease basal dosing |
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