ENDOCRINE Anti Diabetic Agents
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| What is the drug class for anti diabetic agents known as? | Insulin
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| Insulin is the major fuel regulating hormone formed in the ___ cells of the ___ of Langerhans | beta cells; pancreatic islets
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| ____is secreted into the blood in response to a rise in concentration of blood glucose or amino acids | Insulin
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| Insulin is the primary treatment for Type _____ DM | Type 1 DM
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| The primary therapeutic effects is to maintain normal ___ levels which is _____ | Glucose; 60-120 mg/dl
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| What are the three factor of insulin therapy that are important? | 1. Onset
2. Peak
3. Duration
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| ____ is the time required for the medication to have an initial effect or action. | Onset
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| ____ is when the agent will have the maximum effect | Peak
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| ___ is the length of time that the agent remains active in the body | Duration
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| Replace endogenous (produced within) insulin deficiency Increase glucose transport across muscle and fat cell membranes are ___ of _____ | Actions of Insulin
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| Promote conversion of glucose to glycogen Trigger amino acid uptake and conversion to protein in muscle cells Inhibit protein breakdown are ___ of _____ | Actions of Insulin
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| What are the therapeutic uses of Insulin? | Replace endogenous (produced within) insulin deficiency
Increase glucose transport across muscle and fat cell membranes
Promote conversion of glucose to glycogen
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| What are the last two therapeutic uses of Insulin? | Trigger amino acid uptake and conversion to protein in muscle cells
Inhibit protein breakdowd
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| Hypoglycemia (blood glucose levels below 50 mg/dl) is the most serious adverse effect of insulin therapy Hypoglycemia may result from an insulin overdose & may lead to shock & possible death are side effects of ___. | Insulin
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| Tachycardia, palpitations Headache, lethargy, tremors, weakness Blurred vision, dry mouth, hunger, nausea Cold, clammy skin Rash, excess of fat or decrease of fat at injection site are side effects of ___. | Insulin
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| Epinephrine, diuretics, decongestants, marijuana, dilantin and thyroid preparations increase the blood glucose level (cause hyperglycemia) Acetaminophen, salicylates & alcohol decrease the blood glucose level (cause hypoglycemia) interactions are for __ | Insulin
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| Acetaminophen, salicylates and alcohol ____the blood glucose level causing ____. | decrease ; hypoglycemia
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| Insulin is ____ acting | Rapid acting
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| Rapid acting insulin has a ___ solution | Clear
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| Rapid acting Insulin is given ____, usually within ___ minutes of beginning a meal. | subcut; 15 minutes
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| Rapid acting Insulin is contraindicated in patients with episodes of ____ | hypoglycemia
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| Lispro (hymalog), Aspart ( Novolo) are _____ insulin | Rapid acting Inuslin
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| The follow are for what two drugs? Contraindicated in patients with episodes of hypoglycemia Lispro (Humalog), Aspart (Novolog) onset: 5 to 15 minutes peak: 0.5 to 2 hrs duration: 4 to 6 hrs | Lispro (hymalog), Aspart ( Novolo)
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| Acetaminophen, salicylates and alcohol decrease the blood glucose level (cause _____) | hypoglycemia
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| ____ insulin is the only insulin that can be given as continuous intravenous (I.V.) solution | (Short acting)
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| ___ acting insulin is used in medical emergencies | Short acting
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| ___ acting insulin have sources from pork and human. | Short acting
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| What are three types of short acting insulin? | Humulin R, Novolin R, Regular Iletin II
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| The following are for ____ insulin. onset: 0.5 to 1 hr peak: 2 to 4 hrs duration: about 8 hrs | Short acting
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| When regular insulin is administered _____breakfast, hypoglycemia is expected____lunch | before ;before
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| ______acting inulin is given _____ usually ___ minutes ___ breakfast and has a ____ solution. | Intermediate ; subcut; 30 minutes; before; cloudy
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| Human NPH, Lente Onset: 1 to 2 hrs Peak: 4 to 8 hrs Duration: 10-18 hrs are a ___ acting insulin. | Intermediate acting Insulin
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| Intermediate acting insulin is ____ combined with _____ insulin | often; regular
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| ___ acting insulin is ___ used; most frequently combined with ___ acting insulin to provide control through the day and night and has a ___solution | Long acting; rapid acting insulin; cloudy
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| Humulin U Ultralente is a ____ acting insulin. | Long acting insulin
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| Insulin Glargine (Lantus) is a ___ acting insulin. | Long acting
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| Glargine (Lantus) has a __ duration of action; __ to __ hours | long duration; 12 to 24 hours
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| Glargine ( Lantus) ____ peak | Does not
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| Glargine ( Lantus) is given only at ____ | bedtime
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| Glargine (Lantus) is ___ mixed with ____ insulin product | not mixed; any other
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| Glargine (Lantus) has a usually ____ solution | clear
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| Patients may take a rapid-acting insulin for increased glucose levels that occur after meals( postprandial) and an intermediate or long-acting insulin for in between meals when the glucose levels are less this is known as a ___ combination | Fixed combination
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| In U.S.A., premixed syringes ___, ____, and ____) are available | (50/50, 70/30, and 75/25)
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| Subcutaneous regular (either short acting or rapid acting) insulin doses are adjusted according to blood glucose test results is known as ___ scale insulin. | Sliding scale insulin
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| Blood glucose levelved checked ___ or ___ hours or at specific times | Q4 or Q6
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| subcut administered regular insulin is then ordered in an amount that ___ with the ___ in blood glucose | increases;increase
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| Before starting a standardized regimen of____, diet & physical exercise level must be stabilized | insulin therapy
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| ____insulin ___be given ___ | All ; May ; subcutaneously
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| ____ acting insulin is often used to initiate therapy | Intermediate
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| Daily dose may be split into 2 doses: 2/3 given in morning ___ breakfast 1/3 given _____before supper in evening | before; 30 minutes
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| The vial should be gently rolled in the palms of the hands – not ___ | shaken
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| When you store you must store insulin in ____ until opened, then kept at ____ if used within a ___ | refrigerator; room temperature; month
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| ___ use insulin that is ___ or ___ its ___ date | Never;discolored; past; expiration
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| Regular & NPH pre-filled mixture may be stored for ____months Self-mixed stored up to ____ in refrigerator | 2 to 3 ;30 days
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| Regular & lente combination should be used ____ after mixing | immediately
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| Confirm blood glucose level was acceptable for the individual patient Confirm that the patient has had a level of activity reasonable for the individual patient | are pre medication assessment
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| Make sure that the patient is eating & no changes in diet are anticipated Check the order 3 times before administering the medication | are pre medication assessment
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| Always have another licensed nurse check the injection you prepare to be sure it is in accordance with the physician’s order | are pre medication assessment
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| When ____types of insulin are mixed in the same syringe, the regular (____) insulin is always withdrawn first All insulin may be given subcutaneously; regular insulin is the only insulin used I.V. | two ; clear
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| ____insulin is the only insulin used for a ____scale | Regular ; sliding
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| In the U.S., insulin is dispensed as ____ (1 ml = 100 units of insulin) | U 100
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| Insulin syringes are calibrated in ___units | 100
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| Always use an insulin syringe to administer the ____ | injection
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