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Pharmacy NP > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Indications: Concern for cost
1st Gen: Tolbutamide (Orinase), Chlorpropamide (Diabinese)–less effective
2nd Gen: Tolazamide (Tolinase), Glyburide (DiaBeta, Micronase), Glyburide, micronized (Glynase), Glipizide (Glucotrol) Glimepiride (Amaryl)
AE: hypoglycemia & weight gain

A

sulfonyureas

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2
Q

sulfonyureas mechanism

A

potassium

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3
Q

Does not cause hypoglycemia like sulfonylureas
May lower serum lipids
No weight gain
AE: G.I. Distress – 20%, Impaired Vit. B12 absorption
Lactic acidosis:
Potentially serious
Biguanides block the flow of metabolic acids into gluconeogenic cycles.
Incidence is low and predictable.
Avoid in patients with liver disease, CHF, respiratory disease, hypoxemia, severe infection, alcoholism or tendency for acidosis……

A

metformin

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4
Q

we stop when hospitalized.

A

metformin

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5
Q

> 6.5
2-3 months a snap shot
lets us know how well blood glucose was controlled

A

H1C risk is greater than 6.5

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6
Q

the wheel of DM

A
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7
Q

Consider adding insulin to TPN if > 20 units have been administered in 24 HRs

A

2/3 of insulin requirement added to TPN

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7
Q

IV GTT OF INSULIN TRANSITION TO PO?

A

START LANTUS 10 START PRANDIAL COVERAGE

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8
Q

Indications: Concern for hypoglycemia, ASCVD & weight
Gliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance)
AE: Increased risk for UTI’s, Increased urinary frequency, hypotension
Caution with ACE Inhibitors/ARB’s

A

SGC2I

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9
Q

ACIDOSIS IN DM

A

CELLS ARE STARVING

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10
Q

BICARB GIVE WHEN

A

PH <6.9

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11
Q

____________only indicated for pH < 6.9 in DKA patients

A

BICARBONATE

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12
Q

How do you correct the acidosis in DKA

A

IV fluids and insulin

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13
Q

onset of action 3 to 15 minutes

A

lispro aspart glulisine

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14
Q

duration of action insulin 2-4 hours

A

lispro aspart

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15
Q

duration of action insulin 5-8 hours

A

regular insulin

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16
Q

onset of action is 30 minutes

A

regular insulin

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17
Q

peak effect of 2-4 hours

A

regular insulin

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18
Q

peak effect 45-75 minutes

A

lispro aspart

19
Q

onsent of action 2 hours

A

NPH, insulin G D & D

20
Q

these insulin (s) does not have a peak

A

insulin glargine & degludec

21
Q

duration of action is greater than 40 hours

A

insulin degludec

22
Q

peaf effect is 3-9hours

A

insulin detemir

23
Q

duration of action of this insulin is 6-24 hours after

A

insulin detemir

24
Q

this has a duration of action 20->24 hours

A

insulin glargine

25
Q

duration of action 8-18 and an average of 12 hours

A

NPH

26
Q

1st line type 2

A

metformin PO

27
Q

do not bolus

A

d5w

28
Q

level 1 hypoglyecmia

A

<54-70

29
Q

level2 hypoglycemia

A

<54

30
Q

level 3 hypoglycemia

A

clinical deterioration

31
Q

clinical manifestations of hypoglycemia include

A

tremor, palpitations, anxiety/arousal, sweating, hunger and paresthesias *** and check to see if they are not on a beta blocker that can mask

32
Q

brain changes that can happen with hypoglycemia

A

cognitive impairment, behavior changes, psychomotor abnormalities and seizures/coma

33
Q

treatment for level 2/3 hypoglycemia

A

20-50ml of 50% dextrose; infusion of d5w or d10w for level 100mg (goal to this) OR glucoagon 1 mg SC

33
Q

treatment for a mild level 1 hypoglycemia

A

glucose/sugar beverages, milk candy or crackers

34
Q

drug of choice for hypothyroidism

A

levothyroxine stable cheap 7 day half life

35
Q

synthroid

A

bioavaibility is the same as the levothyroxine; just not one dose fists all 20 versus 200 dollars; titrate the dose appropriately

36
Q

side effects of levothyroxine

A

hyperthyroidism

37
Q

high levels of t3 have been associuated with

A

cardiotoxicity

38
Q

graves disease

A

excess; hyper thyroid*thyroid stimulating antibodies

39
Q

goiter can happen in

A

hypo and hyper

40
Q

meds for hyperthyroidsim

A

Thioamines - Methimazole, Propylthiouracil:
Inhibit synthesis of thyroid hormone
Propylthiouracil – also inhibits conversion of T4 to T3

41
Q

works in 3-8 weeks in hyperthyroidism

A

mild cases; in severe cases 18 weeks –> thioamines

42
Q

_____ ________ FOR EALRY SYMPTOMS OF HYPERTHYROIDISM

A

BETA BLOCKERS

43
Q

inhibits conversion of T4 to T3

A

propylthiouracil- for hyperthyroidism

44
Q

black box warning for propylthiouracil

A

bone marrow suppression and hepatitis

45
Q
A

Pharmacy NP (8 decks)

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