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Nursing Exam > Nursing 107 Exam 2 (Diabetes, Diabetes Pharmacology and Infections) > Flashcards

Nursing 107 Exam 2 (Diabetes, Diabetes Pharmacology and Infections) Flashcards

1
Q 
Insulin aspart (Novolog)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Rapid
Onset: 10-20min
Peak: 1-3 hours
Duration: 3-5 hours
Admin and timing: Subcutaneous; 5-10min before a meal
Other considerations: Usually given in combination with a longer acting insulin due to its short duration. It is clear, cannot be given IV.

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2
Q 
Insulin Lispro (Humalog)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Rapid
Onset: 5-15 min
Peak: 1-1.5 hours
Duration: 3-4 hours
Admin and timing: Subcutaneous; 5-10 min before a meal
Other considerations: The fastest acting insulin, give just before eating or even after the meal. It is clear, cannot be given IV.

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3
Q 
Insulin Glulisine (Apidra)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Rapid
Onset: 15-30 min
Peak: 1 hour
Duration: 3-4 hours
Admin and timing: Subcutaneous; 15 min before a meal
Other considerations: Admin no sooner than 15 min before a meal and no later than 20 min after starting a meal.

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4
Q 
Insulin Regular (Humulin R, Novolin R)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Short
Onset: 30-60 min
Peak: 1-5 hours
Duration: 6-10 hours
Admin and timing: Subcutaneous; 30-60 min before meal…MAY BE GIVEN IV
Other considerations: If given IV, it s mixed with saline.

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5
Q 
Isophane susp (NPH, Humulin N) AKA neutral Protamine Hagedorn
What is the action, onset, peak, duration, administration and timing and other considerations?
A 
Action: Intermediate
Onset: 1-2 hours
Peak: 6-14 hours
Duration: 16-24 hours
Admin and timing: Subcutaneous, cloudy
Other considerations: The only intermediate acting insulin.  It must be "rolled" in order to mix it prior to injection.  Can be given with aspart, lispro or regular, but cannot be mixed with glargine.
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6
Q 
Insulin detemir (Levemir)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Long
Onset: gradual
Peak: 6-8 hours
Duration: to 24 hours
Admin and timing: Subcutaneous; 1/day, or 2/day
Other considerations: Slow onset, used to provide basal glucose control. Cannot be mixed with other insulins in the same syringe.

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7
Q 
Insulin glargine (Lantus)
What is the action, onset, peak, duration, administration and timing and other considerations?
A

Action: Long
Onset: 1.1 hours
Peak: No peak
Duration: to 24 hours
Admin and timing: Subcutaneous; 1/day, same time each day
Other considerations: Once daily dosing, provides maintenance of blood glucose levels. CANNOT BE MIXED, less risk of hypoglycemia with this insulin (no peak) and it is clear.

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8
Q

What are the adverse effects of regular insulin?

A

Hypoglycemia (tachycardia, confusion, sweating and drowsiness)
Can become irritated at injection site
Tissue atrophy or hypertrophy

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9
Q

What are the drug interactions of regular insulin?

A

Alcohol, salicylates, anabolic steroids may potentiate signs of hypoglycemia.
Serum glucose levels may be increased with furosemide or thiazide diuretics.
Beta blockers may block signs of hypoglycemia.

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10
Q

When would you hold an insuliin dose?

A

When the blood glucose level is less than 70

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11
Q

What are the s/s of DKA?

A

Develops over days, usually type 1 diabetics.

s/s: polyuria, polydipsia, n/v, and severe fatigue, abdominal pain/tenderness, and breath has a fruity smell.

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12
Q

How do you treat DKA?

A

IV hydration: start with 0.9 NS, then 0.45 NS
Correct electrolyte imbalance
IV insulin bolus - usually based on weight, followed by an insulin drip.

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13
Q

What are the s/s of HHS?

A

Generally seen with type 2 diabetics.
s/s: extreme hyperglycemia, hyperosmolarity with dehydration, absence of ketoacidosis, CNS dysfunction. Patient is usually elderly, with other health conditions such as heart failure or renal impairment.

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14
Q

How do you treat HHS?

A

Treat with fluids, usually a lot - IV insulin, monitor electrolytes, and take care, the patient is frequently elderly with a heart condition.

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15
Q

Which type of insulin can be given intravenoulsy?

A

Human regular insulin

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16
Q

What drug class is glypizide (Glucotrol)?

A

Sulfonylureas

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17
Q

What drug class is metformin (Glucophage)?

A

Biguanides

18
Q

What drug class is repaglinide (Prandin)?

A

Meglitinides

19
Q

What drug class is rosiglitazone (Avandia)?

A

Thiazolinides

20
Q

What drug class is acarbose (Precose)?

A

alpha-gludosidase inhibitor

21
Q

What drug class is sitagliptin (Januvia)?

A

Incretion enhancer

22
Q

What do sulfonylureas do in the body?

A

They stimulate insulin release, increase cellular sensitivity to insulin, which increases insulin binding.

23
Q

What is the onset and duration of sulfonylureas?

A

Onset: 15-30 min
Duration: up to 24 hours

24
Q

What is the primary adverse effect of a sulfonylureas?

A

Hypoglycemia

25
Q

Excessive exercise or alcohol use increases risk of hypoglycemia in what drug class?

A

Sulfonylureas

26
Q

What does metformin (Glucophage) do in the body?

A

Decreases hepatic glucose production and release; increases cellular uptake of glucose, lowers lipid levels, promotes weight loss.

27
Q

What two types of metformin (Glucophage) are there?

A

Regular release and sustained release

28
Q

What are the adverse effects of metformin (Glucophage)?

A

N/V, metallic taste, headache, dizziness and fatigue. Serious adverse effect is lactic acidosis, rare.
May cause acute renal failure and/or lactic acidosis.

29
Q

Who is metformin contraindicated for?

A

Patients with severe renal impairment, drug can rise to toxic levels. Avoid alcohol - increases risk of lactic acidosis.
Contraindicated 2 days prior to and 2 days after receiving IV radiographic contrast. (Acute renal failure may result)

30
Q

What is the overdose treatment for metformin?

A

Dialysis to correct lactic acidosis and remove excess metformin.

31
Q

What is the off label use of metformin (Glucophage)?

A

Polycystic ovary syndrome

32
Q

What does repaglinide (Prandin) do in the body?

A

Stimulate insulin release from pancreatic beta cells; decreases postprandial glucose and hemoglobin A1C; little effect on fasting glucose.

33
Q

How is repaglinide (Prandin) absorbed in the body?

A

Rapidly absorbed, metabolized by the liver, excreted in the feces. Undergoes almost no renal excretion, so can be used in patients with renal impairment.

34
Q

What is the onset, peak and duration of repaglinide (Prandin)?

A

Onset: 15-30 min
Peak: 1 hour
Duration: 4 hours

35
Q

What are the adverse effects of repaglinide (Prandin)?

A

Hypogycemia - otherwise well tolerated

36
Q

What is the overdose treatment for repaglinide (Prandin)?

A

Give glucose-preferably IV

37
Q

Which oral anti-diabetic medication has shown that patients may die from heart failure or incur an MI if given?

A

rosiglitazone (Avandia)

38
Q

What does rosiglitazone (Avandia) do in the body?

A

It decreases hepatic glucose production and secretion; increases cellular sensitivity to insulin.

39
Q

Where is rosiglitazone (Avandia) metabolized in the body?

A

Metabolized in the liver and secreted by the kidneys.

40
Q

What is the onset, peak and duration of Avandia?

A

Onset: within an hour
Peak: at 1 hour
Duration: greater than 24 hours

41
Q

What are some of the adverse effects of Avandia?

A

Edema, can raise serum lipid levels (need to obtain baseline liver function test prior to initiating treatment, then every 3-6 months.

42
Q

Who is Avandia contraindicated with?

A

Persons with heart failure, liver disease, pregnancy and lactation.

Nursing Exam (5 decks)

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