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NRSG 220 > Chapter 66 diabetes > Flashcards

Chapter 66 diabetes Flashcards

1
Q

why is it important to closely monitor a patient that is diabetic and on beta blocker**

A

because beta blockers can mask the S&S of hypoglycemic drugs

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2
Q

what is the only method of administration for Glulisine (Apidra) **

A

given by subcutaneous injection only

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3
Q

what type of insulin is often used in insulin infusion pumps**

A

Insulin lispro (Humalog)

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4
Q

what are the different types of rapid insulin **

A

-lispro
-aspart
-glulisine

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5
Q

What is the onset peak and duration of lispro **

A

Onset: 5-15 min
Peak: 30 min-1h
Duration: 3-4 h

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6
Q

What is the onset peak and duration of aspart**

A

Onset: 15 min
Peak: 1-3 h
Duration: 3-5 h

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7
Q

What is the onset peak and duration of glulisine **

A

Onset: 15-30 min
Peak: 1 h
Duration: 3-4 h

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8
Q

what is the short acting type of insulin **

A

Regular insulin

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9
Q

when is the best time to take rapid acting insulin **

A

best to take it while eating since it has such a short onset

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10
Q

what is the onset peak and duration of regular insulin**

A

onset: 30-60 min
peak: 2-4 h
duration: 5-7 h

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11
Q

when is the best administration time for regular insulin **

A

30 min before a meal

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12
Q

what is the intermediate type of insulin **

A

Isophane

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13
Q

what is the only insulin that is administered IV **

A

regular insulin

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14
Q

what are some adverse effects of insulin therapy**

A

-irritation at injection site
-lipodystrophy
-weight gain

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15
Q

What are some SERIOUS adverse effects of insulin therapy**

A

-hypoglycemia
-rebound hyperglycemia
-hypokalemia

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16
Q

what is the minimum level that a patients blood glucose has to be to administer insulin**

A

Do not administer when blood glucose levels are less than 4 mmol

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17
Q

how often do you have to rotate injection sites to avoid lipodystrophy **

A

rotate injection sites weekly

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18
Q

what parts of the body are most likely to be affected by diabetes**

A

-Eyes
-Heart
-Kidney
-feet

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19
Q

how long can in use vials of insulin be left at room temperature?

A

they can be left up to 4 weeks

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20
Q

does rapid acting insulin have different absorption rates at different sites?

A

no the absorption rate does not vary from site to site

21
Q

if you were drawing a clear insulin and a cloudy insulin into a syringe which would you draw in first?**

A

draw the clear insulin into the syringe first to prevent cloudy insulin from entering the clear insulin bottle

22
Q

who would sulfonylureas be contraindicated for?**

A

-women who are pregnant or breastfeeding
-persons with renal or liver disease

23
Q

how do sulfonylureas help control type 2 diabetes**

A

-stimulate insulin release from the pancreas
-increase sensitivity to insulin receptors

24
Q

what is the suffix that is commonly used for sulfonylureas **

A

Commonly will end in “-ide”

25
Q

what is a common side effect of sulfonylureas **

A

minor GI side effects

26
Q

what is the prototype drug for sulfonylureas

A

glyburide

27
Q

what are the contraindications for sulfonylureas **

A

-Sensitivity to sulfa drugs
-sensitivity to thiazide diuretics
-renal disease
-hepatic disease
-if used during pregnancy discontinue at least 1 month before delivery

28
Q

what are some serious adverse effects that sulfonylureas can cause

A

hepatotoxicity
blood problems

29
Q

how do biguanides help control type 2 diabetes**

A

-decrease glucose production by the liver
-increase insulin sensitivity at tissues
-increases glucose transportation into cells
-decreases intestinal absorption of glucose* (important because this causes the GI side effects)

30
Q

How long does a patient have to take biguanides for until they reach their full therapeutic effect **

A

6-12 weeks for them to reach their therapeutic effect

31
Q

what is the prototype drug for biguanides

A

the prototype and only drug in this classification is metformin

32
Q

what are the contraindications of biguanides*

A

-kidney problems
-liver problems
-heart failure
-hypoxemia (since metformin increases anaerobic cellular respiration and if they have hypoxemia can lead to a buildup of lactic acid)
-pregnancy and lactation
- hyperthyroidism

33
Q

do biguanides cause weight gain**

A

no they do not

34
Q

how long before and after a procedure with contrast dye do biguanides need to be held **

A

need to be held for 48 hours before and 48 hours after a procedure with contrast dyes

35
Q

how do meglitinides help control type 2 diabetes**

A

increase insulin production from the pancreas

36
Q

can meglitinides cause hypoglycemia **

A

yes they can since they stimulate more insulin to be produced

37
Q

what is the suffix that is commonly used for meglitines **

A

“-glinide”

38
Q

what are some contraindications of meglitinides

A

-hepatic impairment (since it is mostly metabolized through the liver)
-pregnancy or lactation
-elderly patients

39
Q

how do Alpha Glucosidase Inhibitors help control type 2 diabetes**

A

block and enzyme in the small intestine that slows the absorption of carbs

40
Q

What is the suffix that is used for alpha glucosidase inhibitors*

A

there is no suffix for this class of medication

41
Q

how do Thiazolidinediones TZD help control type 2 diabetes**

A

-greatly increase insulin sensitivity at target cells
-decrease gluconeogenesis

42
Q

what is the suffix that is used for TZD’s**

A

usually “-glitazone”

43
Q

what organ are TZD’s very hard on **

A

very hard on the liver

44
Q

what are the two classes of incretin enhancers

A

-Activating GLP-1 receptors
-Inhibiting dipeptidyl peptidase 4 (DDP-4)

45
Q

what are the effects of incretin on the body?

A

-increase amount of insulin produced
-decrease amount of glucagon
-delays gastric emptying (slows glucose absorption)
-Increases feelings of satiety

46
Q

how does GLP-1 and DDP-4 inhibitors help to treat type 2 diabetes

A

-GLP-1 are just a replacement so they add more incretins into the system
-DDP-4’s prevents the breakdown of incretins so they remain in the body for longer

47
Q

what is the suffix used for DDP4 inhibitors?

A

“-gliptin”

48
Q

what is the suffix used for GLP-1 agonists?

A

“-glutide”

NRSG 220 (17 decks)

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