Antidiabetic and Endocrine #3 Flashcards
(271 cards)
1
Q
What does the Endocrine system consist of?
A
ductless glands that secrete hormones into the blood stream?
2
Q
What organs are in the Endocrine system?
A
hypothalamus pituitary, parathyroid, thyroid, adrenals, adrenals. pancreas, ovaries, testes
3
Q
What do hormones in the Endocrine system do?
A
chemicals secreted into blood, regulate growth/development, fluid/electrolyte balance, reproduction, adaption to stress, metabolism
4
Q
What are the 4 peptide protein hormones?
A
insulin, vasopressin (ADH), growth (GH), and adrenocorticotropic (ACTH)
5
Q
What are the two amine hormones?
A
epinephrine and norepinephrine
6
Q
What are the three types of steroid hormones?
A
cortisol, estrogen, and testosterone
7
Q
What does an amine hormone do?
A
manipulates hormones that are used as neurotransmitter to control thought processes and the ability to respond to things
8
Q
T/F Steroid molecules look like cholesterol molecules
A
True
9
Q
Where is the Pituitary gland/hypophysis located?
A
at the base of the brain and has two lobes.
10
Q
What is the anterior pituitary gland called?
A
adenohypophysis
11
Q
What does the pituitary “master gland” do?
A
excretes hormones that stimulate the release of hormones from target glands
12
Q
T/F the pituitary gland can be the cause of tertiary problems with other glands such as secondary hypothyroidism.
A
False- causes secondary problems
13
Q
T/F Majority problems come from anterior pituitary.
A
True
14
Q
What hormone influences growth of bones and muscles (doesn’t have a specific target gland)?
A
Growth hormone (somatropin)
15
Q
What does the growth hormone influence?
A
protein, lipid, carbohydrates, and calcium metabolisms
16
Q
What is the name of GH deficiency?
A
dwarfism
17
Q
What is the name of excess GH called?
A
gigantism, acromegaly
18
Q
What is the replacement treatment for GH defiency?
A
somatrem (Protropin) and somatropin (Genotropin) are given before bone epiphyses are fused
19
Q
What can replacement treatment for GH defiency lead to?
A
Diabetes Mellitus
20
Q
When does gigantism occur?
A
during childhood/before puberty
21
Q
When does acromegaly occur?
A
growth after puberty
22
Q
What is the drug treatment for GH excess?
A
octreotide (Sandostatin)
23
Q
What does octreotide (Sandostatin? do?
A
synthetic somatostatin to suppress GH release and is used for severe diarrhea from carcinoid tumors
24
Q
T/F Thyroid stimulating hormone (TSH) is released from the posterior pituitary gland?
A
False- anterior pituitary
25
What does TSH target and do?
targets throid gland, to stimulate production and release of thyroid hormones
26
What is it called if there is no increase in thyroid hormone levels, the problem is with the thyroid gland?
primary hypothyroidism
27
What is it called if drug is given and thyroid hormone level is increased, indicated that thyroid gland is ok, problem is at pituitary level?
secondary hypothyroidism
28
Where is ACTH released and what does it do?
released from anterior pituitary and stimulates release of glucocorticoids (cortisol), mineralocorticoids (aldosterone), androgen from adrenal cortex
29
ACTH corticotropin (Acthar) and Cosyntropin (Cortrosyn) used for? (4)
diagnosis of adrenal gland disorders, treat adrenal insufficiencies, antiinflammatory for allergic response, treat multiple sclerosis/ autoimmune disease
30
T/F Neurohypophysis is released from the posterior pituitary
true
31
What is secreted by the posterior pituitary gland?
ADH (vasopressin) and oxytocin
32
What type of hormone is ADH and what does it do?
Antidiuretic hormone; decreases loss of Na and water through renal tubules; MAINTAINS WATER BALANCE IN BODY
33
What happens with ADH excess?
fluid overload
34
What happens with ADH defiency?
diabetes insipidus, dehydration
35
How do you treat diabetes insipidus?
DDAVP (desmopressin acetate) and vasopressin (Pitressin)
36
What can vasopressin (Pitressin) be used for?
GI bleed and esophagus varices
37
What does DDAVP affect?
clotting
38
What doe oxytocin do?
uterine contraction, milk letdown
39
T/F The thyroid gland secretes T3 and T4.
True
40
What is the function of T3 and T4?
regulates protein synthesis, enzyme activity and to stimulate mitochondrial oxidation
41
Explain Hypothyroidism.
caused by decrease in TSH or thyroid tissue dysfunction causing decreased secretion of T4 andT3; slows a majority of body functions
42
What is the term for very severe hypothyroidism?
Myxedema
43
What drug increases T4 and T3 and makes euthyroid?
levothyroxine (Synthroid)
44
What do you assess for Thyroid gland treatment?
assess for improvement of symptoms, watch cardiac function, drug interactions /t protein binding
45
What does a thyroid overdose look like?
hyperthyroid symptoms; administer drug in morning to avoid sleep disturbances
46
Explain Hyperthyroidism.
caused by overactive thyroid or high TSH (could be thyroid tumor)
47
What is the most common type of hyperthyroidism?
grave's disease
48
What are some side effects/symptoms of Grave's Disease?
tachycardia, palpitation, excessive perspiration, heat intolerance, nervousness, irritability, exophthalmos, and weight loss
49
What is anther name for Grave's Disease and what does it do?
Thyrotoxixosis; increases the rate of the majority of body functions
50
What kills thyroid cells?
radioactive iodine- must have thyroid hormone replaced synthetically after treatment
51
What treatment givers pre-op to reduce size and vascularity?
iodine SSKI (Lugols)
52
What three antithyroid drugs decrease thyroid hormone production?
propylthiouracil (PTU), methimazole (Tapozole), and Sodium iodide IV is used for thyrotoxic crisis
53
What does the parathyroid hormone (PTH) do?
regulates calcium levels by decreasing Ca+ stimulates increasing PTH by mobilizing Ca+ from bone, increasing GI absorption, Increasing renal reabsorption to increase serum calcium
54
What drug takes care of hypocalcemia?
calcitiol (Rocaltrol) (VIT D analogue)
55
What does calcitriol do?
increase GI absorption of Ca+, increase release of Ca+ from bone
56
What are the consequences of calcitriol?
decreased bone density, fractures
57
What are the two structures in the adrenal gland?
adrenal medulla and adrenal cortex
58
How is the Adrenal gland controlled?
through salt, sex, sugar
59
This is aldosterone that regulates Na and water?
mineralcorticoids-salt
60
What regulates some sexual characteristics, but has a small influence?
androgens-sex
61
What controls glucose metabolism and storage and depresses immune system?
Glucocorticoids-sugar
62
T/F Glucocorticoids- sugar are also referred as a stress hormone that is increased release in fight/flight
True
63
What is the classifications of glucocorticoids (Cortisol)?
antiinflammatory, antiemetic effects, an for pain`
64
What are some side effects for glucocorticoids?
abnormal fat deposits (moon face and buffalo hump), muscle wasting, edema, euphoria, psychosis, nightmares, skin thinning, immunosuppression; long term can lead to loss of adrenal gland function
65
What are some drug interactions with steroids?
NSAIDS, diuretics, coumadin due to protein binding
66
What is ketoconazole?
glucocorticoid inhibitors, used to treat client with Cushings syndrome
67
Mineralocorticoids (Aldosterone) does what?
controlled by renin angiotensin system and maintains fluid balance by reabsorption of sodium and water
68
What happens if there is too little aldosterone?
decrease in BP and vascular collapse
69
What is used to treat too little aldosterone and what does it do?
Fludrocoticone (Florinef); oral mineralocorticoid, high protein diet and monitor serum potassium levels, rarely used for elderly
70
What is Cushing's Syndrome?
too much corticosteroid secretion by the Adrenal glands
71
What is Addison's Syndrome?
too little corticosteroid secretion by the Adrenal Glands
72
What are some side effects of drug withdrawal or too little drug resemble Addison's crisis?
low BP, low glucose, lethargy, fatigue, weakness, death
73
What are the routes of administration for corticosteroids?
oral, Im, IV, inhaled, topical, rectal
74
What are corticosteroids used for?
immunosuppression of autoimmune diseases, allergy reaction (Asthma), and transplant therapy
75
Corticosteroids used with chemotherapy in cancer can have what effects?
pain control, control nausea, reduce inflammation related to cell death, and reduce brain swelling
76
Name some nursing interventions for steroids.
check for interactions, don't stop suddenly, dosage adjustment if stressors increase (illness), monitor weight/I&O/K/Na/glucose, may worsen DM, increased appetite, gastric mucosal protection, increase vigilance for infection which symptoms may be decreased
77
What are the three symptoms of DM?
polyuria, polydispsia, polyphagia
78
Why does some with DM experience the three Ps/
increase serum glucose causes osmotic pull of fluid from cells into vascular compartment, then osmotic diuresis in kidney from excess glucose, then thirst due to increased serum osmolarity
79
what does polyphagia mean?
increased hunger
80
what does polydipsia mean?
Increased thirst
81
What is type 1 diabetes?
needs insulin replaced
82
What is type 2 diabetes?
problem with insulin receptors on cells/insulin resistant
83
What is insulin?
promotes uptake of glucose, fatty acids, amino acids by cells
84
Where is insulin secreted?
by beta cells in pancreas
85
Why is insulin secreted?
secreted in response to increased serum levels
86
How does insulin work?
glucose is converted to gylcogen for future glucose needs in liver and muscle, this lowers the blood glucose
87
How is insulin available?
vials, pens, and inhalant
88
What is the name of rapid acting insulin?
lispro (Humalog), aspart (Novolog) glulisine
89
What is the name of short acting insulin?
regular (Humulin)
90
What is the name of Intermediate acting insulin?
NPH, Lente
91
What is the name of long acting insulin?
Detemir (Levemir) and Lantus (Glargine)
92
What is lantus (Glargine)
analog of human insulin, give once/day at bedtime, 24 hr duration, less nighttime hypoglycemia, no peak, no mixing with other insulins
93
What insulins can be combined?
NPH (70) with Regular (30)
94
How does a patient store insulin?
refrigerate unopened vials, if open room temp for one month or in refrigerator for 3 months
95
Who is more common to have insulin resistance?
obese clients
96
What is the main side effect of insulin?
hypoglycemia
97
What causes Ketoacidosis?
caused by lack of insulin, type 1 DM, and is frequently triggered by illness (UTI, URI)
98
What causes hyperosmolar hyperglycemic nonketotic (HHNK)?
lack of insulin, type 2 DM or too much CHO
99
Which insulin should be drawn into the syringe first?
short acting should always be drawn into syringe first if mixing with longer acting insulin
100
T/F Draw the cloudy medication first
false- draw clear then cloudy into syringe
101
When should you give lispro, aspart Insulin?
rapid onset, give within 5-10 minutes before eating, do not mix
102
What insulin can be only given IV?
regular insulin
103
T/F Decreased insulin needed if more exercise happens.
True
104
T/F Less insulin needed if ill.
False- more is needed due to the stress response
105
What is a benefit of Insulin pen Injectors?
convenience= increase compliance
106
What method of administering insulin is available but difficult to regulate?
Intranasal Insulin
107
What is Insulin jet Injectors?
needleless systems that inject insulin
108
What are some benefits of Insulin Pumps?
contains regular insulin, implantable/portable, expeensive, and keep blood glucose levels close to normal because deliver basal dose and then additional dose depending on need
109
What is three criteria for use of oral antidiabetic drugs?
onset of DM at more than 40 years, diagnosis less than 5 years, fasting glucose less than 200 mg, normal renal and hepatic function
110
This drug acts by stimulating secretion of insulin so must have functioning islets is called what?
sulfonylureas
111
What is the first generation sulfonylurea called?
Orinase
112
What is the first generation intermediate acting sulfonylurea called?
Tolinase
113
What is the long acting first generation sulfonylurea called?
Diabinese
114
What are a few characteristics of second generation sulfanylureas?
less drug interactions (more potent), increase tissue response, decrease liver production of glucose, and longer duration
115
What is the second generation sulfonylurea called?
Glipizide (Glucotrol), glyburide (Diabeta), and glimepiride (Amaryl)
116
T/F second generation is used for clients with liver or kidney dysfunction.
false- do not give
117
T/F Sulfonylureas are highly protein binding drugs.
true
118
What does the oral anitdiabetic drug Metformin (Glucophage) do?
decrease hepatic glucose production from stored glycogen, decrease the absorption of glucose from the small intestine, increase insulin receptor sensitivity
119
T/F Metformin doesn't cause hyper or hypoglycemia.
True
120
What classification is Metformin?
Biguanide
121
Why do you need to hold Metformin for 48 hours prior to and after IV use?
Iv contrast dye due to increased risk of lactic acidosis or renal failure
122
What are the two alpha glucosidase inhibitors of oral antidiabetic?
Acarbose (Presode) and Miglitol (Glyset)
123
What do alpha glucosidase inhibitors do?
decrease CHO absorption from intestine doesn't cause hypoglycemia if used alone and frequently used with other oral antidiabetic drugs
124
What are the two Thiazolidinediones called?
Piglitazone (Actos) and Rosiglitazone (Avandia)
125
How does Thiazolidinediones work?
acts by decreasing resistance and can be used in combination with sulfonyureas
126
What are the two Meglitinide drugs called?
Repaglinide (Prandin) and Nateglinide (starlix)
127
How does Meglitinides work?
acts by stimulating the beta cells to release insulin, can be used with metformin, and don't use with liver disease
128
What are the two hyperglycemic drugs?
Glucagon and Diazoxide (Proglycem)
129
What drug is used in emergency for treatment for hyperglycemia?
Glucagon
130
What is Glucagon?
counteracts insulin effects, stimulates glycogen breakdown, use if other method to give glucose not available, given IV/IM/SC
131
What is Diazoxide (Proglycem)?
do not use for emergency use, inhibits insulin release fromthe beta cells, for clients with hyperinsulinism.
132
When is Diazoxide used?
not for emergency use; for clients with hyperinsulinism
133
What does Diazoxide (Proglycem) do?
Inhibits insulin release from beta cells
134
What is the treatment for Hypoglycemia?
eat juice/candy, oral glucose tablets, IV dextrose, Glucagon (SQ, IM, IV)
135
What is the treatment of Hyperglycemia with Insulin?
usually give short acting to cover pre meal, or when expect changes, add intermediate acting when estimated daily needs found and supplement as needed with short acting drug and if emergency may give Regular IV or infusion
136
What is the treatment of hyperglycemia with fluids?
to replenish loss from osmotic diuresis, may need to replace K, start with normal saline then switch to more specific to match loss
137
What organs are in the Endocrine system?
hypothalamus pituitary, parathyroid, thyroid, adrenals, adrenals. pancreas, ovaries, testes
138
What do hormones in the Endocrine system do?
chemicals secreted into blood, regulate growth/development, fluid/electrolyte balance, reproduction, adaption to stress, metabolism
139
What are the 4 peptide protein hormones?
insulin, vasopressin (ADH), growth (GH), and adrenocorticotropic (ACTH)
140
What are the two amine hormones?
epinephrine and norepinephrine
141
What are the three types of steroid hormones?
cortisol, estrogen, and testosterone
142
What does an amine hormone do?
manipulates hormones that are used as neurotransmitter to control thought processes and the ability to respond to things
143
T/F Steroid molecules look like cholesterol molecules
True
144
Where is the Pituitary gland/hypophysis located?
at the base of the brain and has two lobes.
145
What is the anterior pituitary gland called?
adenohypophysis
146
What does the pituitary "master gland" do?
excretes hormones that stimulate the release of hormones from target glands
147
T/F the pituitary gland can be the cause of tertiary problems with other glands such as secondary hypothyroidism.
False- causes secondary problems
148
T/F Majority problems come from anterior pituitary.
True
149
What hormone influences growth of bones and muscles (doesn't have a specific target gland)?
Growth hormone (somatropin)
150
What does the growth hormone influence?
protein, lipid, carbohydrates, and calcium metabolisms
151
What is the name of GH deficiency?
dwarfism
152
What is the name of excess GH called?
gigantism, acromegaly
153
What is the replacement treatment for GH defiency?
somatrem (Protropin) and somatropin (Genotropin) are given before bone epiphyses are fused
154
What can replacement treatment for GH defiency lead to?
Diabetes Mellitus
155
When does gigantism occur?
during childhood/before puberty
156
When does acromegaly occur?
growth after puberty
157
What is the drug treatment for GH excess?
octreotide (Sandostatin)
158
What does octreotide (Sandostatin? do?
synthetic somatostatin to suppress GH release and is used for severe diarrhea from carcinoid tumors
159
T/F Thyroid stimulating hormone (TSH) is released from the posterior pituitary gland?
False- anterior pituitary
160
What does TSH target and do?
targets throid gland, to stimulate production and release of thyroid hormones
161
What is it called if there is no increase in thyroid hormone levels, the problem is with the thyroid gland?
primary hypothyroidism
162
What is it called if drug is given and thyroid hormone level is increased, indicated that thyroid gland is ok, problem is at pituitary level?
secondary hypothyroidism
163
Where is ACTH released and what does it do?
released from anterior pituitary and stimulates release of glucocorticoids (cortisol), mineralocorticoids (aldosterone), androgen from adrenal cortex
164
ACTH corticotropin (Acthar) and Cosyntropin (Cortrosyn) used for? (4)
diagnosis of adrenal gland disorders, treat adrenal insufficiencies, antiinflammatory for allergic response, treat multiple sclerosis/ autoimmune disease
165
T/F Neurohypophysis is released from the posterior pituitary
true
166
What is secreted by the posterior pituitary gland?
ADH (vasopressin) and oxytocin
167
What type of hormone is ADH and what does it do?
Antidiuretic hormone; decreases loss of Na and water through renal tubules; MAINTAINS WATER BALANCE IN BODY
168
What happens with ADH excess?
fluid overload
169
What happens with ADH defiency?
diabetes insipidus, dehydration
170
How do you treat diabetes insipidus?
DDAVP (desmopressin acetate) and vasopressin (Pitressin)
171
What can vasopressin (Pitressin) be used for?
GI bleed and esophagus varices
172
What does DDAVP affect?
clotting
173
What doe oxytocin do?
uterine contraction, milk letdown
174
T/F The thyroid gland secretes T3 and T4.
True
175
What is the function of T3 and T4?
regulates protein synthesis, enzyme activity and to stimulate mitochondrial oxidation
176
Explain Hypothyroidism.
caused by decrease in TSH or thyroid tissue dysfunction causing decreased secretion of T4 andT3; slows a majority of body functions
177
What is the term for very severe hypothyroidism?
Myxedema
178
What drug increases T4 and T3 and makes euthyroid?
levothyroxine (Synthroid)
179
What do you assess for Thyroid gland treatment?
assess for improvement of symptoms, watch cardiac function, drug interactions /t protein binding
180
What does a thyroid overdose look like?
hyperthyroid symptoms; administer drug in morning to avoid sleep disturbances
181
Explain Hyperthyroidism.
caused by overactive thyroid or high TSH (could be thyroid tumor)
182
What is the most common type of hyperthyroidism?
grave's disease
183
What are some side effects/symptoms of Grave's Disease?
tachycardia, palpitation, excessive perspiration, heat intolerance, nervousness, irritability, exophthalmos, and weight loss
184
What is anther name for Grave's Disease and what does it do?
Thyrotoxixosis; increases the rate of the majority of body functions
185
What kills thyroid cells?
radioactive iodine- must have thyroid hormone replaced synthetically after treatment
186
What treatment givers pre-op to reduce size and vascularity?
iodine SSKI (Lugols)
187
What three antithyroid drugs decrease thyroid hormone production?
propylthiouracil (PTU), methimazole (Tapozole), and Sodium iodide IV is used for thyrotoxic crisis
188
What does the parathyroid hormone (PTH) do?
regulates calcium levels by decreasing Ca+ stimulates increasing PTH by mobilizing Ca+ from bone, increasing GI absorption, Increasing renal reabsorption to increase serum calcium
189
What drug takes care of hypocalcemia?
calcitiol (Rocaltrol) (VIT D analogue)
190
What does calcitriol do?
increase GI absorption of Ca+, increase release of Ca+ from bone
191
What are the consequences of calcitriol?
decreased bone density, fractures
192
What are the two structures in the adrenal gland?
adrenal medulla and adrenal cortex
193
How is the Adrenal gland controlled?
through salt, sex, sugar
194
This is aldosterone that regulates Na and water?
mineralcorticoids-salt
195
What regulates some sexual characteristics, but has a small influence?
androgens-sex
196
What controls glucose metabolism and storage and depresses immune system?
Glucocorticoids-sugar
197
T/F Glucocorticoids- sugar are also referred as a stress hormone that is increased release in fight/flight
True
198
What is the classifications of glucocorticoids (Cortisol)?
antiinflammatory, antiemetic effects, an for pain`
199
What are some side effects for glucocorticoids?
abnormal fat deposits (moon face and buffalo hump), muscle wasting, edema, euphoria, psychosis, nightmares, skin thinning, immunosuppression; long term can lead to loss of adrenal gland function
200
What are some drug interactions with steroids?
NSAIDS, diuretics, coumadin due to protein binding
201
What is ketoconazole?
glucocorticoid inhibitors, used to treat client with Cushings syndrome
202
Mineralocorticoids (Aldosterone) does what?
controlled by renin angiotensin system and maintains fluid balance by reabsorption of sodium and water
203
What happens if there is too little aldosterone?
decrease in BP and vascular collapse
204
What is used to treat too little aldosterone and what does it do?
Fludrocoticone (Florinef); oral mineralocorticoid, high protein diet and monitor serum potassium levels, rarely used for elderly
205
What is Cushing's Syndrome?
too much corticosteroid secretion by the Adrenal glands
206
What is Addison's Syndrome?
too little corticosteroid secretion by the Adrenal Glands
207
What are some side effects of drug withdrawal or too little drug resemble Addison's crisis?
low BP, low glucose, lethargy, fatigue, weakness, death
208
What are the routes of administration for corticosteroids?
oral, Im, IV, inhaled, topical, rectal
209
What are corticosteroids used for?
immunosuppression of autoimmune diseases, allergy reaction (Asthma), and transplant therapy
210
Corticosteroids used with chemotherapy in cancer can have what effects?
pain control, control nausea, reduce inflammation related to cell death, and reduce brain swelling
211
Name some nursing interventions for steroids.
check for interactions, don't stop suddenly, dosage adjustment if stressors increase (illness), monitor weight/I&O/K/Na/glucose, may worsen DM, increased appetite, gastric mucosal protection, increase vigilance for infection which symptoms may be decreased
212
What are the three symptoms of DM?
polyuria, polydispsia, polyphagia
213
Why does some with DM experience the three Ps/
increase serum glucose causes osmotic pull of fluid from cells into vascular compartment, then osmotic diuresis in kidney from excess glucose, then thirst due to increased serum osmolarity
214
what does polyphagia mean?
increased hunger
215
what does polydipsia mean?
Increased thirst
216
What is type 1 diabetes?
needs insulin replaced
217
What is type 2 diabetes?
problem with insulin receptors on cells/insulin resistant
218
What is insulin?
promotes uptake of glucose, fatty acids, amino acids by cells
219
Where is insulin secreted?
by beta cells in pancreas
220
Why is insulin secreted?
secreted in response to increased serum levels
221
How does insulin work?
glucose is converted to gylcogen for future glucose needs in liver and muscle, this lowers the blood glucose
222
How is insulin available?
vials, pens, and inhalant
223
What is the name of rapid acting insulin?
lispro (Humalog), aspart (Novolog) glulisine
224
What is the name of short acting insulin?
regular (Humulin)
225
What is the name of Intermediate acting insulin?
NPH, Lente
226
What is the name of long acting insulin?
Detemir (Levemir) and Lantus (Glargine)
227
What is lantus (Glargine)
analog of human insulin, give once/day at bedtime, 24 hr duration, less nighttime hypoglycemia, no peak, no mixing with other insulins
228
What insulins can be combined?
NPH (70) with Regular (30)
229
How does a patient store insulin?
refrigerate unopened vials, if open room temp for one month or in refrigerator for 3 months
230
Who is more common to have insulin resistance?
obese clients
231
What is the main side effect of insulin?
hypoglycemia
232
What causes Ketoacidosis?
caused by lack of insulin, type 1 DM, and is frequently triggered by illness (UTI, URI)
233
What causes hyperosmolar hyperglycemic nonketotic (HHNK)?
lack of insulin, type 2 DM or too much CHO
234
Which insulin should be drawn into the syringe first?
short acting should always be drawn into syringe first if mixing with longer acting insulin
235
T/F Draw the cloudy medication first
false- draw clear then cloudy into syringe
236
When should you give lispro, aspart Insulin?
rapid onset, give within 5-10 minutes before eating, do not mix
237
What insulin can be only given IV?
regular insulin
238
T/F Decreased insulin needed if more exercise happens.
True
239
T/F Less insulin needed if ill.
False- more is needed due to the stress response
240
What is a benefit of Insulin pen Injectors?
convenience= increase compliance
241
What method of administering insulin is available but difficult to regulate?
Intranasal Insulin
242
What is Insulin jet Injectors?
needleless systems that inject insulin
243
What are some benefits of Insulin Pumps?
contains regular insulin, implantable/portable, expeensive, and keep blood glucose levels close to normal because deliver basal dose and then additional dose depending on need
244
What is three criteria for use of oral antidiabetic drugs?
onset of DM at more than 40 years, diagnosis less than 5 years, fasting glucose less than 200 mg, normal renal and hepatic function
245
This drug acts by stimulating secretion of insulin so must have functioning islets is called what?
sulfonylureas
246
What is the first generation sulfonylurea called?
Orinase
247
What is the first generation intermediate acting sulfonylurea called?
Tolinase
248
What is the long acting first generation sulfonylurea called?
Diabinese
249
What are a few characteristics of second generation sulfanylureas?
less drug interactions (more potent), increase tissue response, decrease liver production of glucose, and longer duration
250
What is the second generation sulfonylurea called?
Glipizide (Glucotrol), glyburide (Diabeta), and glimepiride (Amaryl)
251
T/F second generation is used for clients with liver or kidney dysfunction.
false- do not give
252
T/F Sulfonylureas are highly protein binding drugs.
true
253
What does the oral anitdiabetic drug Metformin (Glucophage) do?
decrease hepatic glucose production from stored glycogen, decrease the absorption of glucose from the small intestine, increase insulin receptor sensitivity
254
T/F Metformin doesn't cause hyper or hypoglycemia.
True
255
What classification is Metformin?
Biguanide
256
Why do you need to hold Metformin for 48 hours prior to and after IV use?
Iv contrast dye due to increased risk of lactic acidosis or renal failure
257
What are the two alpha glucosidase inhibitors of oral antidiabetic?
Acarbose (Presode) and Miglitol (Glyset)
258
What do alpha glucosidase inhibitors do?
decrease CHO absorption from intestine doesn't cause hypoglycemia if used alone and frequently used with other oral antidiabetic drugs
259
What are the two Thiazolidinediones called?
Piglitazone (Actos) and Rosiglitazone (Avandia)
260
How does Thiazolidinediones work?
acts by decreasing resistance and can be used in combination with sulfonyureas
261
What are the two Meglitinide drugs called?
Repaglinide (Prandin) and Nateglinide (starlix)
262
How does Meglitinides work?
acts by stimulating the beta cells to release insulin, can be used with metformin, and don't use with liver disease
263
What are the two hyperglycemic drugs?
Glucagon and Diazoxide (Proglycem)
264
What drug is used in emergency for treatment for hyperglycemia?
Glucagon
265
What is Glucagon?
counteracts insulin effects, stimulates glycogen breakdown, use if other method to give glucose not available, given IV/IM/SC
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What is Diazoxide (Proglycem)?
do not use for emergency use, inhibits insulin release fromthe beta cells, for clients with hyperinsulinism.
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When is Diazoxide used?
not for emergency use; for clients with hyperinsulinism
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What does Diazoxide (Proglycem) do?
Inhibits insulin release from beta cells
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What is the treatment for Hypoglycemia?
eat juice/candy, oral glucose tablets, IV dextrose, Glucagon (SQ, IM, IV)
270
What is the treatment of Hyperglycemia with Insulin?
usually give short acting to cover pre meal, or when expect changes, add intermediate acting when estimated daily needs found and supplement as needed with short acting drug and if emergency may give Regular IV or infusion
271
What is the treatment of hyperglycemia with fluids?
to replenish loss from osmotic diuresis, may need to replace K, start with normal saline then switch to more specific to match loss
