Drugs Affecting the Endocrine System Flashcards
(26 cards)
Insulin Rules/Test Tips
- Give food during peaks and monitor for low sugar
- Deadly hypoglycaemia (70 or less, give sugar)
* Shaky, pale, cool, sweat or clammy
*awake = ask them to eat
*sleeping - Stab with IV D50 - no peak No mix = long acting, draw up in two separate syringes
- IVP/IV only = regular insulin
- Draw up clear to cloudy
- Rotate locations, best on abdomen near umbilicus
- DKA type 1 “give on sick days”
Long acting insulin
No peak
No mix
Detemir
Glargine
Duration: 24 hours
NPH
Intermediate
Never IV
Always mix
Mix clear to cloudy
Given 2x a day
Duration 14 hours
Peak: 4-12 hours
(most at risk 5.5hours)
Regular Insulin
Ready to go IV
Only IV insulin
Duration 5-8 hours
Peak 2-4 hours
Rapid
Aspart/Lispro/Gluisine
Give during meals
Must be eating in 10-15min
Duration 3-5 hors
Most deadly
15min onset
Peak 30-90 minutes
What is the fastest way to kill your diabetic client
Not giving a plate of food during peak times
Insulin Infusion Pump
Steady doses of insulin
fewer blood sugar swings
Check BG 4x per day
Insulin bolus at meal times
Insulin pump malfunctioning
Always assess patient first, pump second
Oral Agents Rules
Decrease blood glucose
Use after exercise and diet have failed
Never take with TC meds
Iron
Calcium
Anti acids
Oral Agents Type 2 Diabetes
Metformin
Glipiziide and Glyburide
Thiazolidinedione
Pioglitazone
Acarbose and precose
Avoid alcohol and liver disease patients
Metformin
Mini chance of low sugar
Major liver + kidney toxic
Hold 48 hours before cath lab since contrast kills the kidneys
Glipiziide and Glyburide
Stimulate pancreas to release insulin
Bad for heart failure and MI history
Slow pistons
Watch IDE ending not a diuretic
Cause weight gain and sunburn
Toxic for elderly patients
Thiazolidinedione
Pioglitazone
Reduces insulin resistance
Heart and liver toxic
Risk of HF
Acarbose and precose
Massive flatus and diarrhea
Digest foods for you
Not given to IBS
Levothyroxine
Hypothyroidism
Leaves T3 and T4 in the body
No cure, Life long drug, never stop taking
Long slow onset 3-4 weeks
Early morning
Empty stomach, 30-60 before breakfast 1x daily, no doubling doses
Never stop abruptly
Report s/s of hyperthyroidism (agitation and confusion)
Pregnancy safe
What medication to avoid with hypothyroidism
Narcotics and sedatives (benzos)
Hyperthyroidism Drugs
Methimazole: not baby safe
Propylthiouracil: baby safe, report fever and sore throat
SSKI: potassium iodide, shrinks the thyroid before removal, strains teeth, keep 1 hour apart from other thyroid meds
Beta blockers: propanolol
RAIU radioactive Iodine Uptake
Destroys thyroid in one dose
Hypothyroid s/s
Makes patient Radioactive
Before giving radioactive Iodine Uptake
Negative pregnancy test
Remove neck jewelry and dentures
5-7 days before hold antithyroid meds
Awake - no anesthesia or conscious sedation
NPO 2-4 hours before 1-2 hours after
After giving radioactive Iodine Uptake
Avoid everyone for up to 7 days
No crowds
No same restroom (flush 3 times)
Not same food utensils
Not same laundry as family
No cuddling or kissing
Steroids
Stress and swelling hormone
“SONE”
prednisone
Dexamathasone
Hydrocortisone
Fludrocortisone
Given to help the body respond to inflammation and stress
Inflamed lungs - COPD
inflamed joints - rheumatoid arthritis
Inflamed skin - psoriasis
inflamed body - lupus/allergic reactions
Steroids side effects
Swollen (water gain and weight gain)
Sepsis - infection or illness
Low WBC, 37.8
Sugar increase (normal) = Hyperglycemia, steroids increase sugar too we need to increase the insulin
Skinny muscles and bones, risk for osteoporosis
Sight, risk for cataracts, referrer to optometrist
Prevent addisonian crisis
Slowly taper off (never abruptly stop)
Stress/surgery - increase dose with increase stress
The nurse should be concerned when the clients states “I have a sore on my leg that won’t go away”
Which medication should be reviewed with HCP
Dexamethasone
Hydrocortisone
