anti-diabetic drugs

Question 1

what is the major stimulus in the regulation of insulin secretion

Answer 1

glucose

Question 2

incretin hormones in the GI tract stimulate..

Answer 2

the release of insulin when glucose levels are normal or elevated

Question 3

cortisol, GH, epinephrine, estrogen and progesterone all..

Answer 3

raise blood glucose levels

Question 4

excessive prolonged endogenous secretion of insulin can exhaust..

Answer 4

pancreatic beta cells and can cause or aggravate DM

Question 5

some factors that inhibit insulin secretion are?

Answer 5

hypoxia, hypothermia, surgery and severe burns (ie. stress)

Question 6

DM type 1:

Answer 6

-autoimmune disorder destroys pancreatic beta cells (life long disease)

Question 7

DM type 2:

Answer 7

-insulin resistance & hyperglycemia

Question 8

signs and symptoms of DM

Answer 8

-hyperglycemia, glucosuria, polydipsia, polyruia, dehydration, polyphagia

Question 9

complications of DM include

Answer 9

-MI, Stroke, blindness, leg amputation and kidney failure

Question 10

lispro and insulin aspart are _________ insulin’s

Answer 10

short acting

Question 11

intermediate acting insulin’s have

Answer 11

added protamine and or zinc

Question 12

insulin glargine is _______

Answer 12

long acting, used to provide basal amount

Question 13

insulin is not used if _____________

Answer 13

DM is controlled by diet

Question 14

when mixing insulin’s?

Answer 14

draw up rapid/short acting insulin first, then immediate acting insulin, use immediately

Question 15

the insulin pump uses _______ acting insulin

Answer 15

rapid acting, others use regular insulin

Question 16

Oral hypoglycemics and anti-hyperglycemics:

sulfonylureas (glyburide)

Answer 16

increase secretion of insulin

Question 17

Oral hypoglycemics and anti-hyperglycemics:

alpha-glucosidase inhibitors (acarbose)

Answer 17

delay digestion of complex carbohydrates into glucose

Question 18

Look at videos in red on powerpoint…

Answer 18

YES

Question 19

Oral hypoglycemics and anti-hyperglycemics:

-Biguanide (ALSO called Metformin)

Answer 19

Increases use of glucose by muscle and fat, decreases hepatic glucose production and decreases intestinal absorption of glucose

Question 20

Oral hypoglycemics and anti-hyperglycemics:

-Glitazones (Actos)

Answer 20

-insulin sensitizers decrease insulin resistance by stimulating receptors on muscle, fat, and liver cells

Question 21

Oral hypoglycemics and anti-hyperglycemics:

-Meglitinides (nateglinide)

Answer 21

-stimulate pancreatic secretion of insulin

Question 22

Oral anti-diabetic agents can be used in various combinations for…

Answer 22

additive fact

Question 23

Sulfonylureas and meglitinides may have interactions with

Answer 23

beta blockers and alcohol may have additive hypoglycemic effects with concurrent use

Question 24

concurrent use of thiazide diuretics and _______ may raise blood glucose levels and thereby counteract the effects of insulin

Answer 24

glucocorticoids

Question 25

beta blockers may mask..

Answer 25

SNS response to hypoglycemia (tachycardia, tremors), making it difficult for clients to identify hypoglycemia

Question 26

Insulin dosage may need to be increased in response to ..

Answer 26

- increase in caloric intake - infection - stress - growth spurts - in second and third trimesters of pregnancy

Question 27

Insulin dosage may need to be decreased

Answer 27

- in response to level of exercise | - first trimester of pregnancy

Question 28

Instruct clients to administer subcutaneous insulin in one general area to have consistent rates of absorption. absorption rates from subcut admin__________ from thigh to upper arm to abdomen

Answer 28

increase

Question 29

oral anti-diabetics: rapidly decrease glucose so

Answer 29

have food available

Question 30

Hypoglycemia if abrupt onset

Answer 30

client will experience sympathetic nervous system (SNS) effects (tachycardia, palpitations, diaphoresis, shakiness)

Question 31

Hypoglycemia if gradual onset

Answer 31

client will experience parasympathetic (PNS) manifestations (headache, tremor, weakness)

Question 32

if Hypoglycemia occurs administer..

Answer 32

snack of 15g carbohydrates, 4 oz orange juice, 2 oz grape juice, 8 oz milk, glucose tablets equal to 15g

Question 33

what is the best measure of glycemic control?

Answer 33

glycosated hemoglobin (HGB AIC)

Question 34

what is a good HGB AIC level?

Answer 34

less than 6.5%

Question 35

Children with type 1 DM high risk for

Answer 35

delayed growth and development

Question 36

Goals of diabetic education?

Answer 36

- self-management/self care - good glycemic control - HBA1C less than 7% - FBG between 4-7mmol/L - monitor glucose levels and urine ketones

Question 37

_____ or _______ when combined with either glyburide or metformin increase blood glucose

Answer 37

-Beta-blockers or alcohol