Pharm Test 3
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| Glucose Regulation |
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| What is the role of the pancreas? | To produce insulin, release sodium bicarb, and release pancreas enzymes
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| What is the role of insulin? | It is a hormone produced in the pancreas, when the blood glucose increases too much insulin gets released into the blood
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| What are other factors that effect it? | Adipose hormones, SNS, Corticosteroids, and growth hormone
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| What is Dibetes Mellitus? | It is a sugar disease, alteration in metabolism of carbs, proteins and fats
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| What is a clinical sign of Diabetes Mellitus? | Fasting blood glucose level of >126
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| What is hyperglycemia? | Random blood sugar of >200, pt will be fatigued, lethargic, will be very thirsty
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| What is Hypoglycemia? | Random blood sugar of <40, pt will have a headache, blurred vision, sweating and can lead to coma
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| What is Type 1 Diabetes? | Happens in children; is the destruction of pancreatic cells, caused by virus which makes them not able to produce insulin
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| What is type 2 diabetes? | Occurs in adults and children; usually adults, can be changed with lifestyle modification
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| What are the types of insulin? | Many types
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| What is the action of insulin? | It helos the body store glucose and converts it to glycogen (storage)
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| What is insulin indicated for? | Type 1 and 2 Diabetes
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| What is it contraindicated with? | Nothing unless the pt doesn't need it
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| What are some adverse reactions of insulin? | Ketoacidosis, S&S of Hypoglycemia
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| What are some drug to drug interactions? | MAOIs, beta blockers, aspirin, alchohol
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| What are the nursing implications for insulin? | Assess glucose levels, chack for acidosis, pt will have fruity breath, establish a baseline, diet and exercise teaching
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| What three insulins are in the rapid acting type? | Humalog (Lispro), Novolog (Aspart), and Apidra (Giullsine)
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| What is the onset of the rapid acting insulins? | 15-20 minutes
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| When should you usually give these to a patient? | Give with patients meal
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| What is the peak of the rapid acting insulins? | 30-90 minutes
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| What is the duration of the rapid acting insulins? | 2-5 hrs
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| What 2 insulins are regular (R) insulins? | Humulin R, and Novalin R
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| What is the onset of the regular insulins? | 30 minutes
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| When would you usually give these to a patient? | About 30 min before breakfast
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| What is the peak of the regular insulins? | 2-5 hrs
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| What is the duration of the regular insulins? | 4-8 hrs
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| What are the 2 types of NPH (intermediate acting) insulins? | Humulin N and Novalin N
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| What is the onset of these? | 2-4 hrs
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| What is the peak of the intermediate NPH insulins? | 4-12 hrs
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| What is the duration of intermedicate NPH insulins? | 14-18 hrs (Humulin N) and up to 24hrs (Novalin N)
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| What are the types of Pre-mixed insulins? | Humalog 75/25 (intermediate/shorter acting regular), Humulin 70/30, Novalin 70/30, Humulin 50/50, and Novolulix 30
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| What is the onset of the pre-mixed insulins? | 15-30 min
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| What is the peak for the pre-mixed insulins? | 2-12 hrs
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| What is the duration of the pre-mixed insulins? | 18-26 hrs
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| What are peakless basal insulins? | Once a day insulins, that you DO NOT mix
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| What are the two types of peakless basal insulins? | Lantus (Glargine) and Levemir
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| What is the onset of these? | 1-4 hrs
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| Is there a peak for these? | NO
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| What is the duration of the peakless basal insulins? | Up to 24 hrs
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| What types of insulins can you mix? | Rapid acting, Regular, and NPH intermediate acting
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| Which two types of insulin can you NOT mix? | Pre-mixed and Peakless basal
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| What two drugs are in the classification: Sulfonylureas? | Chlorpropamide and Glyburide
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| What is the trade name for Chlorpropamide? | Diabinese
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| What is the trade name for Glyburide? | Micronase
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| What is the action of the sulfonyureas? | They bind to potassium channels in the pancreas which improves insulin binding receptors in pancreas
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| What is the indication for sulfonyureas? | Type 2 diabetics
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| What are contraindications of sulfonyureas? | No diet and exercise, allergy to drug, if the pt doesn't have a pancreas, or type 1 diabetes
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| What is the adverse reaction for sulfonyureas? | Hypoglycemia S&S
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| What are the drug to drug interactions of sulfonyureas? | Beta blockers and alcohol
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| What are the nursing implications of the sulfonyureas? | Teaching client, baseline, good medical hx, other drugs they are currently on
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| What is the drug in the classification: Biguanide? | Metformin
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| What is the trade name of Metformin? | Glucophage
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| What is the action of Biguanides? | It increases the utilization of insulin; increases the uptake of glucose and absorption of it in the small intestine; does not cause hypoglycemia
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| What is the indication of Biguanides? | Adjunct for type 2 diabetes and used for children less than or equal to 10 years of age
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| What are Biguanides contraindicated with? | Liver and kidney diseases
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| What are some adverse reactions of Biguanides? | Hypoglycemia, lactic acidosis, and N/V
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| What are the drug to drug interactions? | A lot, need to look up
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| What are the nursing implications for Biguanides? | Baseline, chack labs and blood sugar, hold if pt is going into surgery
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| What is the drug in the classification: Glucose- Elevating agents? | Glucagon
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| What is the action of Glucagon? | Brings the blood sugar up and raises the level of glucose
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| What is the indication of Glucagon? | A blood sugar of <40
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| What are the adverse reactions of Glucagon? | N/V
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| What are the drug to drug interactions with Glucagon? | Antioagulants (increases the effect of the anticoagulant)
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| What are the nursing implications of Glucagon? | Get a baseline assessment, check glucose levels, and safety of pt
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| What are the special considerations for children and diabetes? | Need to monitor for S&S of hypoglycemia in type 1 diabetics; Teens may need special care to encourage them to continue diet and exercise
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| What is the only drug that can be used for children with type 2 diabetes? | Metformin (Glucophage)
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| What are some special considerations for older adults and diabetes? | May have complications from diabetes; need to monitor liver and kidney function; need to assess compliance w/ diet and exercise; may need to adjust care to accomodate visual changes and tactile changes; need to monitor feet and skin carefully
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