Flashcards in Ch39 Diabetes Deck (27)
What are contraindications of insulin
Sulfonylureas, meglitinides, beta blockers, and alcohol have a additive hypoglycemic effect with concurrent use. Monitor for levels less than 50.
Thiazide diuretics and glucocorticoids may raise blood glucose levels counteracting the insulin
Beta blockers may mask SNS response to hypoglycemia such as tachycardia and tremors making it difficult to distinguish between hypoglycemia.
When drawing short and long acting insulin what should u do
Draw the short acting first then the long acting, this prevents the possibility of injecting some of the ,one acting into the short acting.
What 2 insulins are both clear in color and not administered via IV Aand should not be mixed in a syringe with any other insulin.
Insulin glaring and insulin detemir
What route should NPH insulin be administered
How should lispro, aspart, glulisine and regular insulin be administered
What should you educate clients about regarding SC insulin
Administer in one general area to have consistent rates of absorption
Absorption rates for SC tissue increase from thigh to upper arm to abdomen.
Name rapid acting insulins
Lispro ( humalog)
Insulin aspart ( novolog)
Insulin glulisine ( apidra)
Rapid acting insulin has a onset of 15-30 min peaks in 30min -2.5 hr
Name short acting insulins
Regular insulin ( humulin -R)(novolin R)
It has a onset of 30-1hr. And peaks in 1-5 hr
Name intermediate acting insulins
Insulin detemir (levemir)
What is the pharmalogical action of insulin
1. Promotes cellular uptake of glucose ( decreases glucose)
2. Converts glucose into glycogen
3. Moves potassium into cells along with glucose.
What are adverse effects of insulin use
Risk for hypoglycemia
Lipohypertrophy/ inject injection sites and allow 1 inch between injection sites.
What are medication interactions of insulin
1. Sulfonylureas, meglitinides,beta blockers, and alcohol can have a additive hypoglycemic effect
2. Concurrent use of thiazide diuretics and glucocorticoids may raise blood glucose levels and thereby counteract the effects of insulin
How should short acting insulins always appear
DO NOT ADMINISTER CLOUDY OR DISCOLORED
Oral anti diabetics
1. Sulfonylureas-chlorpropamide ( Diabinese)glipizide (glucotrol)tolzamide,
glyburide ( DiaBeta), glimepiride ( amaryl)
2. Meglitinides-repaglinide ( Prandin), nateglinide ( Starlix)
Both classes of drugs release insulin from the pancreas.
What does the oral anti diabetic drug metformin do
It reduced the production of glucose within the liver thru supression of glucogenesis, it also increases muscles' glucose uptake and use
Metformin is in the drug class BIGUANIDES
What are thiazolidinediones ( glitazones) do
They are an oral anti diabetic drug that increases cellular response to insulin by decreasing insulin resistance
It increases glucose uptake and decreased glucose production
What is the prototype thiazolidinediones
Pioglitazone ( actos)
What do alpha glucosidase inhibitors do
Slows carbohydrate absorption and digestion
What is the prototype alpha glucosidase inhibitor
Miglitol ( glyset)
What are glipitines
They are augments naturally occurring in retain hormones which promote release of insulin and decreases secretion of glucagon
It lowers fasting and postprandial blood glucose levels
What is the prototype glipitines
Sitagliptin ( Januvia)
What are the drug classes of oral anti diabetic drugs
What is metformin also used for
It,is used to treat poly cystic ovary syndrome ( Pcos)
What are adverse effects of glipizide and repaglinide
What are adverse effects of metformin
1. GI effects such as anorexia, nausea, vomiting; resulting in wt loss.
2. Vit b12 and folic acid deficiency caused by altered absorption.
3."lactic acidosis ( hyperventilation, myalgia, sluggishness, somnolence, 40% mortality rate
What are adverse effects of pioglitazone ( thiazolidinediones)
Elevations in LDLS