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NURS 3303 > Hematopoieticc, Diabetic, and GI > Flashcards

Hematopoieticc, Diabetic, and GI Flashcards

1
Q

Epoetin Alfa (Epogen) MOA

A

induces erythropoiesis and release of reticulocytes from the bone marrow to the bloodstream for maturation via parenteral admin

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2
Q

Epoetin Alfa (Epogen) indications

A
  • anemia or CRF
  • chemo-induced anemia of non-myeloid malignancies
  • HIV pts w/ Zidovudine
  • pre-op for anemic pts prior to elective surgery
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3
Q

Epoetin Alfa (Epogen) AEs

A
  • HTN
  • inc risk for MI, CVA, and HF
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4
Q

Epoetin Alfa (Epogen) nursing considerations

A
  • do not agitate vial before preparing med
  • monitor CV status, CMP, and Fe panel
  • monitor CBC, Hgb
  • monitored under REMS
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5
Q

filgrastim (Neupogen) MOA

A

stimulates production, maturation, and activation of neutrophils to inc both their migration and cytotoxicity via parenteral admin

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6
Q

filgrastim (Neupogen) indications

A
  • myelosuppressive chemotherapy
  • chemo + BMT of non-myeloid origin
  • severe chronic neutropenia
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7
Q

filgrastim (Neupogen) AEs

A
  • bone pain
  • leukocytosis
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8
Q

filgrastim (Neupogen) nursing considerations

A
  • do not agitate vial before prepping med
  • monitor for pain and utilize appropriate analgesics PRN
  • monitor CBC and d/c once ANC reaches 10,000
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9
Q

romiplostim (Nplate) MOA

A

peptide mimetic that increases platelet counts by binding to and activating human thrombopoietin receptor

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10
Q

romiplostim (Nplate) indications

A

pts undergoing myelosuppressive radiation and those with immune thrombocytopenia

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11
Q

romiplostim (Nplate) AEs

A
  • abd pain
  • dizziness and headache
  • arthralgia
  • oropharyngeal pain
  • thromboembolism
  • progression of existing MDS to AML
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12
Q

romiplostim (Nplate) nursing considerations

A
  • careful dosage calc needed; only admin with syringe with 0.01 mL graduations
  • monitor CBC, PLT should be > 50,000
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13
Q

rapid acting insulin MOA

A

stimulates uptake of glucose, amino acids, nucleotides, and K+

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14
Q

rapid acting insulin indications

A

postprandial glycemic control in Type I and II DM

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15
Q

rapid acting insulin AEs

A
  • hypoglycemia
  • hypokalemia
  • lipohypertrophy
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16
Q

rapid acting insulin nursing considerations

A
  • est baseline labs and monitor glucose
  • rotate injection sites
  • clear formulation; don’t use if cloudy or discolored
  • can be admin AC and soon PC
  • educate on admin and storage instructions
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17
Q

rapid acting insulin names

A
  • Humalog
  • Novolog
  • Apidra
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18
Q

rapid acting insulin onset time

A

10-30 minutes

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19
Q

rapid acting insulin peak time

A

30 minutes - 3 hours

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20
Q

rapid acting insulin duration

A

3-5 hours

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21
Q

short acting insulin MOA

A

stimulates uptake of glucose, amino acids, nucleotides, and K+

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22
Q

short acting insulin AEs

A
  • hypoglycemia
  • hypokalemia
  • lipohypertrophy
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23
Q

short acting insulin nursing considerations

A
  • est baseline labs and monitor glucose
  • rotate injection sites
  • clear formulations
  • clear formulation; don’t use if cloudy or discolored
  • admin 20-30 min AC and soon PC
  • can be mixed with other insulins in the same syringe
  • educate on admin and storage instructions
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24
Q

short acting insulin name

A

Regular (R)

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25
Q

short acting insulin onset time

A

30-60 minutes

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26
Q

short acting insulin peak time

A

1-5 hours

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27
Q

short acting insulin duration

A

6-10 hours

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28
Q

intermediate acting insulin MOA

A

stimulates uptake of glucose, amino acids, nucleotides, and K+

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29
Q

intermediate acting insulin indications

A

glycemic control between meals and during night

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30
Q

intermediate acting insulin AEs

A
  • hypoglycemia
  • hypokalemia
  • lipohypertrophy
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31
Q

intermediate acting insulin nursing considerations

A
  • est baseline labs and monitor glucose
  • rotate injection sites
  • cloudy formulation
  • admin 2-3x/day; not meal dependent
  • can be mixed with rapid and short acting insulin
  • educate on admin and storage instructions
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32
Q

intermediate acting insulin brand

A

NPH (N)

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33
Q

intermediate acting insulin onset

A

60-120 minutes

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34
Q

intermediate acting insulin peak

A

6-14 hours

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35
Q

intermediate acting insulin duration

A

16-24 hours

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36
Q

long acting insulin MOA

A

stimulates uptake of glucose, amino acids, nucleotides, and K

37
Q

long acting insulin indications

A

basal glycemic control

38
Q

long acting insulin AEs

A
  • hypoglycemia
  • hypokalemia
  • lipohypertrophy
39
Q

long acting insulin nursing considerations

A
  • est baseline labs and monitor glucose
  • rotate injection sites
  • clear formulation
  • usually admin HS but can be 2x/day
  • educate on admin and storage instructions
40
Q

long acting insulin names

A

Lantus and Levemir

41
Q

Lantus onset

A

70 minutes

42
Q

Lantus peak

A

none

43
Q

Lantus duration

A

18-24 hours

44
Q

Levemir onset

A

60-120 minutes

45
Q

Levemir peak

A

12-24 hours

46
Q

Levemir duration

A

varies

47
Q

metformin (Glucophage) MOA

A

lowers glucose through several mechanisms, but does not stimulate insulin release

48
Q

metformin (Glucophage) indications

A

Type II and gestational DM

49
Q

metformin (Glucophage) AEs

A
  • GI effects
  • toxicity-related lactic acidosis
  • decreased B12 and folic acid absorption
50
Q

metformin (Glucophage) nursing considerations

A
  • educate on LA signs
  • monitor for renal impairment
  • stop for elective contrast CT and for admission
  • B12 and folic acid supplementation as needed
  • potential for weight loss vs PO meds
51
Q

glipizide (Glucotrol) indications

A

Type II DM

52
Q

glipizide (Glucotrol) AEs

A
  • hypoglycemia (more likely w/ liver and kidney dysfunction)
  • very rarely, SJS/TENS and CV toxicity
53
Q

glipizide (Glucotrol) nursing considerations

A
  • educate and monitor for hypoglycemia signs
  • contraindicated during pregnancy and breastfeeding
  • instruct pts to avoid ETOH
  • concurrent use with beta-blockers can diminish sulfonylurea benefits
54
Q

pioglitazone (Actos) MOA

A

activates PPAR gamma to turn on insulin-responsive genes that are responsible for carb and lipid metabolism

55
Q

pioglitazone (Actos) indications

A

type II DM

56
Q

pioglitazone (Actos) AEs

A
  • HF 2/2 fluid retention (especially if pre-existing)
  • ovulation in premenopausal women
  • inc risk of fractures in women
  • bladder CA
57
Q

pioglitazone (Actos) nursing considerations

A
  • educate and monitor for s/s of HF
  • assess GU history and ROS
  • interactions with CYP2C8 inhibitors (atorvastatin, rifampin, etc)
58
Q

acarbose (Precose) MOA

A

delays absorption of dietary carbs to reduce postprandial hyperglycemia by inhibiting alpha glucosidase that is needed for complex carb catabolism

59
Q

acarbose (Precose) indications

A

type II DM

60
Q

acarbose (Precose) AEs

A
  • GI-related
  • liver dysfunction
  • anemia
61
Q

acarbose (Precose) nursing considerations

A
  • if used with insulin, hypoglycemia treatment w/ glucose only
  • monitor LFT and s/s liver functions
62
Q

canagliflozin (Invokana) MOA

A

inhibits SGLT-2 to block reabsorption of filtered glucose, leading to glucosuria

63
Q

canagliflozin (Invokana) indications

A

type II DM

64
Q

canagliflozin (Invokana) AEs

A
  • female GU fungal infections and UTI
  • postural HOTN and dizziness
  • lower limb amputation (rare)
65
Q

canagliflozin (Invokana) nursing considerations

A
  • educate on GU infections
    -fall precautions
  • monitor for new pain, soreness, ulcers, etc in lower limbs
66
Q

sitagliptin (Januvia) MOA

A

enhances actions of incretin hormones to stimulate glucose-dependent release of insulin and suppress postprandial release of glucagon by inhibiting DPP-4

67
Q

sitagliptin (Januvia) indications

A

type II DM; usually adjunctive therapy to metformin

68
Q

sitagliptin (Januvia) AEs

A
  • generally well-tolerated
  • pancreatitis
  • hypersensitivity
69
Q

sitagliptin (Januvia) nursing considerations

A
  • educate and monitor s/s of pancreatitis
  • educate and monitor for rash and allergy
70
Q

exenatide (Byetta) MOA

A

activates GLP-1 receptors to cause same effects as endogenous incretins

71
Q

exenatide (Byetta) indications

A

type II DM

72
Q

exenatide (Byetta) AEs

A
  • GI upset
  • increased risk of pancreatitis and renal impairment
  • hypersensitivity rxns
73
Q

exenatide (Byetta) nursing considerations

A
  • educate and monitor s/s of pancreatitis, rash, and allergy
  • educate pt on different types of injectable medications
74
Q

famotidine (Pepcid) MOA

A

selectively blocks H2 receptors to reduce gastric secretions into GI tract

75
Q

famotidine (Pepcid) indications

A
  • duodenal and gastric ulcers; GERD
  • Zollinger-Ellison syndrome
  • aspiration pneumonitis
  • heartburn, sour stomach, etc.
76
Q

famotidine (Pepcid) AEs

A
  • CNS related
  • pneumonia
77
Q

famotidine (Pepcid) nursing considerations

A
  • does need to take regarding meals
  • educate pts on lifestyle measures to use with pharmacotherapy
78
Q

pantoprazole (Protonix) MOA

A

inhibits H+, K+, ATPase to prevent generation of gastric acid

79
Q

pantoprazole (Protonix) indications

A
  • duodenal and gastric ulcers; GERD
  • Zollinger-Ellison syndrome
  • aspiration pneumonitis
  • stress ulcer prophylaxis
80
Q

pantoprazole (Protonix) AEs

A
  • minor w/ short-term use
  • fractures
  • rebound acid hypersecretion
  • dec Mg w/ long-term use
  • c.diff diarrhea
81
Q

pantoprazole (Protonix) nursing considerations

A
  • enteric coated and tablets cannot be crushes, opened, chewed, etc.
  • take before meals
82
Q

sucralfate (Carafate) MOA

A

antiulcer medication that undergoes polymerization to create gel that adheres to ulcer crater and creates barrier against acid and pepsin

83
Q

sucralfate (Carafate) indications

A

duodenal and gastric ulcers

84
Q

sucralfate (Carafate) AEs

A
  • constipation
  • no known serious effects
85
Q

sucralfate (Carafate) nursing considerations

A
  • may impede absorption of some meds
  • minimize by admin at least 2 hours apart from other meds
86
Q

antacids MOA

A

react w/ gastric acid to produce neutral salts/lower acidity salts

87
Q

antacids indications

A

peptic ulcer disease

88
Q

antacids AEs

A
  • constipation and/or diarrhea
  • sodium loading with Na compounds
89
Q

antacids nursing considerations

A
  • may impeded absorption of some medications
  • minimize by admin at least 1 hour apart from other meds

NURS 3303 (10 decks)

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