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Pharmacology > Module 4 - Blood Glucose Agents, Vitamins & Minerals > Flashcards

Module 4 - Blood Glucose Agents, Vitamins & Minerals Flashcards

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1
Q

What organ monitors glucose regulation?

A

Pancreas

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2
Q

What are the two glands included in the pancreas?

A
  1. Endocrine Gland
  2. Exocrine Gland
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3
Q

What is the endocrine gland responsible for?

A

Produces hormones in the islets of Langerhans

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4
Q

What is the exocrine gland responsible for?

A
  1. Releases sodium bicarbonate and pancreatic enzymes directly into the common bile duct to be released into the small intestine
  2. Neutralizes the acid chyme from the stomach and aids digestion
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5
Q

Define insulin

A
  1. Hormone produced by beta cells of the islets of Langerhans
  2. Released into circulation when levels of glucose around these cells rise
  3. Stimulates glycogen synthesis, conversion of lipids into fat stored as adipose tissue, and synthesis of proteins from amino acids
  4. Released after meals, causing glucose levels to fall
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6
Q

Define glucagon

A

-Released from alpha cells into islets of Langerhans in response to low blood glucose
2. Causes immediate mobilization of glycogen stored in the liver and raises blood glucose levels

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7
Q

Define adipocytes

A
  1. Secretes adiponectin
    - increases insulin sensitivity
    - decreases release of glucose from liver
    - protects blood vessels from inflammation
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8
Q

Define endocannabinoid receptors

A
  1. Keep the body in a state of energy pain to prepare for stressful situations
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9
Q

Sympathetic nervous system function

A
  1. decreases insulin release
  2. increases release of stored glucose
  3. Increases fat breakdown
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10
Q

Corticosteroids function

A
  1. Decreases insulin sensitivity
  2. Increases glucose release
  3. Decreases protein building
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11
Q

Growth hormone function

A
  1. Decreases insulin sensitivity
  2. Increases FFAs
  3. Increases protein building
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12
Q

Hyperglycemia

A

Increased blood sugar

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13
Q

Glycosuria

A

Sugar is spilled into the urin

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14
Q

Polyuria

A

Increased urination

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15
Q

Polyphagia

A

Increased hunger

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16
Q

Polydipsia

A

Increased thirst

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17
Q

Lipolysis

A

Fat breakdown

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18
Q

Ketosis

A

Ketones cannot be removed effectively

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19
Q

Acidosis

A

Liver cannot remove all of the waste products

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20
Q

Characteristics of diabetes mellitus

A
  1. Complex disturbances in metabolism
  2. Affects carbohydrates, protein, and fat metabolism
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21
Q

Clinical signs of diabetes mellitus

A
  • Hyperglycemia (fasting blood sugar level greater than 126 mg/dl)
    -Glycosuria
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22
Q

Vascular damage

A

Occurs after long term results from diabetes mellitus

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23
Q

What are the disorders related to diabetes

A
  1. Atherosclerosis
  2. Retinopathy
  3. Neuropathies
  4. Nephropathy
  5. Infections
  6. Foot ulcers
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24
Q

Define atherosclerosis

A
  1. Heart attacks and strokes related to the development of atherosclerotic plaques in the vessel lining
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25
Define retinopathy
1. With resultant loss of vision as tiny vessels in the eye are narrowed and closed
26
Define neuropathies
1. With motor and sensory changes in the feet and legs and progressive changes in other nerves as the oxygen is cut off
27
Define nephropathy
1. With renal dysfunction related to changes in the basement membrane of the glomerulus
28
Define infections
1. Increases in frequency and severity due to decreased blood flow and altered neutrophil function
29
Define foot ulcers
1. Decreased wound healing due to vascular insufficiency 2. Unnoticed wounds and infections due to neuropathy decreasing perception of pain
30
What are the classifications of diabetes mellitus
1. Type 1, Insulin-Dependent DM (IDDM) 2. Type 2, Non-Insulin-Dependent DM (NIDDM) 3. Diabetes due to other causes 4. Gestational Diabetes
31
What are clinical signs and symptoms of hyperglycemia (9)
1. Fatique 2. Lethargy 3. Irritation 4. Glycosuria (sugar spilled into urine) 5. Polyuria (increased urination) 6. Polyphagia (Increased hunger) 7. Polydipsia (Increased thirst) 8. Frequent infections 9. Poor wound healing
32
Signs of dangerous complications of hyperglycemia
1. Fruity Breath - Ketones build up in the system and are excreted through the lungs 2. Dehydration - Fluid and important electrolytes are lost through the kidneys 3. Fast, Deep Respirations - Body tries to rid itself of high acid levels 4. Loss of orientation and coma
33
What level is a indication of hyperglycemia
Blood glucose < 70 mg/dL
34
What is the initial response of hyperglycemia
Parasympathetic stimulation followed by "fight or flight" action
35
What occurs during parasympathetic stimulation and "fight or flight" action
1. Breakdown of fat and glycogen to release glucose 2. Pancreas releases glucagon to increase glucose and somatostatin
36
What are S/S of hypoglycemia (8)
-Shakiness -Dizziness -Sweating -Hunger -Tachycardia -Inability to concentrate -Confusion -Irritability or moodiness
37
Important information about children taking anti diabetic agents (6)
1. Monitor closer for hyper- and hypoglycemia 2. Insulin often needs to be diluted due to small dosages 3. Two nurse check for insulin 4. Challenging to treat in teens 5. Team approach - family, teachers, coaches, etc 6. Metformin is the only oral DM drug approved
38
Important information about adults taking anti diabetic agents (3)
1. Emphasize diet and exercise 2. Caution about OTC, herbal, and alternative therapies 3.Insulin is best choice in pregnancy and lactation.
39
Important information about older adults taking anti diabetic agents (5)
1. Underlying problems complicate diabetic therapy 2. Dietary deficiencies lead to fluctuations in glucose levels 3. Renal or hepatic impairment may make oral agents not feasible. 4. Emphasize diet, exercise, skin and foot care 5. More likely to experience end organ damage
40
Actions of Insulin
1. Hormone that promotes the storage of the body's fuels 2. Facilitates the transport of various metabolites and ions across cell membranes 3. Simulates the synthesis of glycogen from glucose 4. Reacts with specific receptor sites on the cells.
41
What are the indications of insulin
1. Treatment of type 1 DM 2. Treatment of type 2 DM in patients whose diabetes cannot be controlled by diet or other agents
42
What are the contraindications of insulin
1. None except episodes of hypoglycemia
43
What are the cautions of insulin
1. Pregnancy and lactation
44
What are the adverse effects of insulin
1.Hypoglycemia 2.Ketoacidosis 3.Local site reactions 4.Decreased blood potassium levels
45
What are the drug-drug interactions of insulin
1. Any drug that decreases glucose levels 2. Beta blockers 3. Thiazide diuretics 4. Glucocorticoids
46
What is the onset, peak, and duration of regular insulin?
Onset: 30-60 min Peak: 2-4 hours Duration: 6-12 hours
47
What is the onset, peak, and duration of NPH insulin?
Onset: 1 - 1.5 hours Peak: 4 - 12 hours Duration: 24 hours
48
What is the onset, peak, and duration of inhaled insulin?
Onset: 12 - 15 minutes Peak: 60 minutes Duration: 2.5 - 3 hours
49
What is the onset, peak, and duration of lispro insulin?
Onset: less than 15 minutes Peak: 30 - 90 minutes Duration: 2 - 5 hours
50
What is the onset, peak, and duration of aspart insulin?
Onset: 10 - 20 minutes Peak: 1 -3 hours Duration: 3 - 5 hours
51
What is the onset, peak, and duration of glargine insulin?
Onset: 60 - 70 minutes Peak: None Duration: 24 hours
52
What is the onset, peak, and duration of glulisine insulin?
Onset: 2 - 5 minutes Peak: 30 - 90 minutes Duration: 2 hours
53
What is the onset, peak, and duration of detemir insulin?
Onset: 1 - 2 hours Peak: 3 - 6 hours Duration: 5.7 - 23.3 hours
54
What are the combination insulins?
1. Humalog 50/50 2. Humalog 75/25 3. NovoLog 70/30 4. Humulin 70/30 5. Novolin 70/30
55
What is included in the assessment of insulin? (6)
1. Contraindications and cautions 2. Skin lesions; orientation and reflexes; complications with poor blood glucose control 3. Body systems for changes suggesting possible complications associated with poor blood glucose control 4. Nutritional intake 5. Activity level, degree of exercise 6. Obtain blood glucose levels as ordered; monitor HgB A1C, urinalysis, BMP
56
What is included in the nursing diagnosis of insulin? (6)
1. Glucose and electrolyte imbalance risk r/t insulin use 2. Malnutrition risk r/t changes in glucose transport 3. Altered sensory perception 4. Infection risk r/t injections and disease processes 5. Coping impairment r/t diagnosis and need for injection therapy 6. Knowledge deficit risk regarding drug therapy.
57
What is included in the implementation of insulin? (16)
1. Ensure pt is following a diet and exercise program; good hygiene 2. Gently rotate vial containing the agent; don't shake 3. Select a site that is free of bruising and scarring 4. Give maintenance doses by subcu or inhaled routes only 5. Monitor response carefully 6. Monitor pt for s/s of hypoglycemia 7. Always verify insulin name before giving 8. Use caution when mixing insulin 9. Store insulin in cool place 10. Monitor pt during times of severe stress 11. Monitor intake; ensure pt eats 12. Monitor pt exercise and activity 13. Protect pt from infection; good skin and foot care 14. Monitor pt sensory losses 15. Help pt deal with lifestyle changes 16. Provide patient teaching
58
What is included in the evaluation of insulin?
1. Monitor pt response to drug (BGL) 2. Monitor for adverse effects 3. Effectiveness of teaching Px 4. Compliance with regimen
59
What are the first and second generation sulfonylureas?
1st: Tolbutamide 2nd: Glipizide, Glyburide
60
What do first generation sulfonylureas drugs do?
Associated with increased risk of cardiovascular disease
61
What do second generation sulfonylureas drugs do?
Same as 1st generation with advantages of: -Don't interact with many protein-bound drugs -Have a longer duration of action, only needed once or twice a day
62
What is the action of sulfonylureas?
1. Stimulate insulin release from beta cells in pancreas 2. Improve binding to insulin receptors
63
What are the indications of sulfonylureas?
1. Adjunct to diet and exercise to lower blood glucose levels in type 2 diabetes
64
What are the contraindications of sulfonylureas drugs?
1. Allergy 2. Diabetic complications 3. Type 1 diabetes mellitus 4. Pregnancy and lactation
65
What are the adverse effects of sulfonylureas?
1. Hypoglycemia 2. GI distress 3. Allergic skin reactions
66
What are the drug-drug interactions of sulfonylureas?
1. Beta blockers 2. Alcohol 3. Herbal remedies
67
Define biguanides
A first-line medication choice for people with type 2 diabetes
68
List biguanides
Metformin
69
What is the action of biguanides
1. Decreases production and increases uptake of glucose 2. Lowers both basal and postprandial glucose levels 3. Decreases hepatic glucose production 4. Improves insulin sensitivity of peripheral cells.
70
What is the indications of biguanides
1. First line treatment for type 2 diabetes
71
What are the contraindications of biguanides?
1. Hypersensitivity 2. Metabolic acidosis 3. Sever renal impairment
72
What are the cautions of biguanides? (6)
1. Hepatic impairment 2. Excessive alcohol intake 3. NPO status 4. Radiologic contrast 5. Age 65 and older 6. Hypoxic state
73
What are the adverse effects of biguanides?
1. Black box warning: lactic acidosis 2. GI effects 3. Dizziness; headache 4. URI 5. Taste disturbance
74
What are the drug-drug interactions of biguanides?
1. Alcohol 2. Carbonic anhydrase 3. Iodine containing contrast media
75
List DPP-4 Inhibitors
"-gliptin" 1. Sitagliptin
76
What is the action of DPP-4 Inhibitors
1. Slow inaction of incretin hormones - Increase insulin release - Decrease glucagon release
77
What are the indications of DPP-4 Inhibitors?
1. Adjunct to diet and exercise in type 2 diabetes
78
What are the contraindications of DPP-4 Inhibitors?
1. Hypersensitivity 2. Type 1 diabetes or DKA
79
What are the cautions of DPP-4 Inhibitors?
1. Renal impairment
80
What are the adverse effects of DPP-4 Inhibitors?
1. Drug effects are rarely reported
81
What are the drug-drug interactions of DPP-4 Inhibitors?
1. Other medications that lower blood glucose
82
List the meglitinides
"-glinide" 1. Repaglinide 2. Nateglinide
83
What are the actions of meglitinides?
1. Stimulates insulin release from the beta cells in the pancreas
84
What are the indications of meglitinides?
1. Adjunct to diet and exercise in type 2 diabetes
85
What are the contraindications of meglitinides?
1. Hypersensitivity 2. Type 1 DM or DKA
86
What are the cautions of meglitinides?
1. Pregnancy and lactation
87
What are the adverse effects of meglitinides?
1. Upper respiratory infections (URI) 2. Headache 3. Arthralgias 4. Nausea, diarrhea, hypoglycemia
88
What are the drug-drug interactions of meglitinides?
1. Numerous
89
List SGLT-2 Inhibitors
"-gliflozin" 1. Canagliflozin
90
What are the actions of SGLT-2 Inhibitors?
1. Blocks co-transporter system so glucose is not reabsorbed but is lost in the urine
91
What are the indications of SGLT-2 Inhibitors?
1. Adjunct to diet and exercise in type 2 DM 2. Research being done on use in type 1 DM
92
What are the contraindications of SGLT-2 Inhibitors?
1. Type 1 DM or DKA 2. Severe renal impairment 3. Pregnancy (2nd or 3rd trimester)
93
What are the cautions of SGLT-2 Inhibitors?
1. Lactation
94
What are the adverse effects of SGLT-2 Inhibitors?
1. Dehydration, hypotension 2. UTIs, genital fungal infections 3. DKA 4. Lower limb amputations
95
What are the drug-drug interactions of SGLT-2 Inhibitors?
Numerous
96
List the thiazolidinediones
"-glitazone" 1. Pioglitazone
97
What are the actions of thiazolidinediones?
1. Decreases insulin resistance in peripheral cells and liver 2. Increases responsiveness to insulin
98
What are the indications of thiazolidinediones?
1. Adjunct to diet and exercise in type 2 DM
99
What are the contraindications of thiazolidinediones?
1. Moderate to severe heart failure
100
What are the cautions of thiazolidinediones?
1. Liver impairment
101
What are the adverse effects of thiazolidinediones?
1. URI 2. Headaches, muscle pain 3. Increased total cholesterol 4. Rapid weight gain and edema
102
What are the drug-drug interactions of thiazolidinediones?
1. Numerous
103
List the GLP-1 Agonists
"-glutide" "-natide" 1. Semaglutide 2. Exenatide
104
What are the actions of GLP-1 Agonists?
1. Increases insulin resistance 2. Decreases glucagon release 3. Slow GI emptying
105
What are the indications of GLP-1 Agonists?
1. Adjunct to diet and exercise in type 2 DM 2. Reduce risk of major CV events in type 2 DM
106
What are the contraindications of GLP-1 Agonists?
1. Type 1 DM or DKA 2. Pregnancy and lactation
107
What are the adverse effects of GLP-1 Agonists?
1. GI effects 2. Pancreatitis
108
What are the drug-drug interactions of GLP-1 Agonists?
1. Other anti diabetic medications 2. Oral medications: effects may be slowed
109
What is included in the assessment of non insulin antidiabetic agents? (6)
1. Contraindications/cautions 2. Complete physical assessment 3. Presence of any skin lesions 4. Nutritional intake 5. Activity level, amount and degree 6. BGL, urinalysis, renal/liver function
110
What is included in the nursing diagnosis of non insulin antidiabetic agents? (6)
1. Hyperglycemia risk r/t DM disease process 2. Hypoglycemia r/t dosing of anti-diabetic agents 3. Coping impairment r/t diagnosis and therapy 4. Knowledge deficit with drug therapy
111
What is included in the implementation of other anti diabetic agents
1. Administer drug as prescribed 2. Ensure patient follows diet and exercise 3. Monitor nutrional status 4. Monitor response carefully; blood glucose monitoring 5. Monitor during times of trauma, stress, pregnancy 6. Provide pt teaching
112
What is included in the evaluation of other anti diabetic agents
1. Response to drug (stabilization of glucose) 2. Adverse effects 3. Effectiveness of teaching plan 4. Compliance with regimen
113
Severe hypoglycemia and assistance requires?
Glucagon when glucose is below 70 mg/dL
114
What are the actions of glucose elevating agents?
1. Increases BGL be decreasing insulin release and accelerating the breakdown of glycogen in the liver to release glucose
115
What are the indications of glucose elevating agents?
Treatment of hypoglycemia
116
What are the contraindications of glucose elevating agents?
1. Known allergy 2. Pregnancy
117
What are the cautions of glucose elevating agents?
1. Lactation 2. Hepatic dysfunction, renal dysfunction, or cardiac disease
118
What are the adverse effects of glucose elevating agents?
1. GI upset 2. Alteration in BP
119
What are the drug-drug interactions of glucose elevating agents?
1. Anticoagulants
120
What is included in the assessment of glucose elevating agents?
1. Contraindications and cautions 2. Complete physical assessment 3. Orientation and reflexes and baseline pulse, BP, Adventitious sounds, and BS 4. Glucose levels and appropriate lab values
121
What is included in the nursing diagnosis of glucose elevating agents?
1. Risk for unstable blood glucose related to ineffective dosing of drug 2. Malnutrition risk more than body requirements r/t metabolic effects, and less than body requirements related too GI upset 3. Altered sensory perception 4. Knowledge deficit regarding d/t
122
What is included in the implementation of glucose elevating agents?
1. Monitor blood glucose levels 2. Have insulin on standby during emergency use 3. Monitor nutritional status 4. Patient teaching
123
What is included in the evaluation of glucose elevating agents?
1. Response to drug 2. Adverse effects 3. Effectiveness of teaching plan 4. Compliance with regimen
124
What are the characteristics of vitamins?
1. Substances that the body requires for carrying out essential metabolic reactions 2. Body cannot synthesize enough of these components to meet all of it's needs 3. Must be obtained from animal and vegetable tissues as food
125
What are the characteristics of minerals?
1. Naturally occurring inorganic substances 2. Important for normal functioning of the human body 3. Taken in via diet 4. Some are also electrolytes
126
What are the actions of vitamins and minerals?
1. Build bones 2. Make hormones 3. Regulate fluid volume 4. Generate nerve action potentials 5. Produce RBC
127
What are the indications of vitamins and minerals
1. Treatment deficiencies, as dietary supplements, and a specific therapy related to the activity of the vitamin and mineral
128
What are the contraindications of vitamins and minerals
1. Allergy to the drug of the colorants, additives, or preservatives 2. Levels are high in the body
129
What are the adverse effects of vitamins and minerals
1. Gastrointestinal upset
130
What are the drug-drug interactions of vitamins and minerals
1. Fat soluble vitamins (may not be absorbed if given concurrently with mineral oil, cholestyramine, or colestipol) 2. Potassium and potassium-sparing diuretics 3. Magnesium and calcium decreases absorption of antibiotics and iron
131
List the vitamins discussed
1. Ascorbic acid 2. Calcifediol 3. Cholecalciferol 4. Cyanocobalamin 5. Ergocalciferol 6. Niacin 7. Phytonadione 8. Thiamine 9. Vitamin A 10. Vitamin E
132
What are the two classes of vitamins
1. Water-soluble 2. Fat-soluble
133
What are the characteristics of water-soluble vitamins
1. Dissolve in water 2. Readily excreted in urine 3. Daily intake in needed -Vitamin B complex -Vitamin C
134
What are the fat-soluble vitamins
1. Dissolve in fat 2. Tend to be stored in the lover and daily intake not necessary -Vitamin A -Vitamin D -Vitamin E -Vitamin K
135
Vitamin A indications
1. Deficiency and malnutrition 2. Wound healing
136
Signs of Vitamin A deficiency
1. Night blindness and other vision problems 2. Impaired skin integrity
137
What is hypervitaminosis A and signs of it?
Vitamin A toxicity 1. Mouth ulcers 2. Cracked fingernails 3. Bone pain 4. Loss of appetite 5. Cracked corners of the mouth 6. Blurry vision or other vision changes 7. Dizziness
138
Indications for ascorbic acid administration (Vitamin C)
-Deficiency (scurvy is severe deficiency) -Enhances PO iron absorption -Wound healing
139
Signs of vitamin C deficiency
1. Gingivitis 2. Hair and tooth loss 3. Nosebleeds, easy bruising, delayed healing
140
Adverse effects of ascorbic acid
1. Kidney stones
141
What is used for vitamin C deficiency?
1. Ascorbic acid
142
What is used for Vitamin D deficiency?
1. Calcifediol 2. Cholecalciferol 3. Ergocalciferol
143
What are indications of low vitamin D levels?
1. Deficiency 2. Malnutrition
144
What are signs of low vitamin D levels?
1. Rickets 2. Osteomalacia 3. Osteoporosis 4. Tetany
145
What are indications of hypervitaminosis D? (9)
1. Fatigue 2. Loss of appetite 3. Weight loss 4. Excessive thirst 5. Excessive urination 6. Dehydration 7. Constipation 8. Irritability 9. Nervousness
146
What is used for low levels of Vitamin B12
Cyanocobalamin
147
What are indications of cyanocobalamin
1. Pernicious anemia 2. Deficiency and malnutrition 3. ETOH 4. Malabsorption syndrome 5. Vegan diet 6. Prolonged use of PPIs or H2 blockers
148
What are signs of Vitamin B12 deficiency
1. Megaloblastic anemia 2. Mucous membranes -Cheilosis -Glossitis -Stomatitis 3. Neurologic -Paresthesias -Balance problems -Memory loss -Thinking problems
149
What are indications of Vitamin E deficiency?
1. Mostly in premature infants 2. Vitamin E levels may be low in metabolic syndrome 3. Wound healing
150
What are signs of vitamin E toxicity?
1. Nausea 2. Gastric distress 3. Abdominal cramps 4. Diarrhea 5. Headache 6. Fatigue 7. Easy bruising and bleeding
151
What are indications for administration of niacin
1. Pellegra 2. Lipid-lowering agent
152
What are signs of niacin deficiency
1. Mucous membranes -cheilosis -glossitis -stomatitis
153
Adverse effects of niacin deficiency
1. Flushing of skin 2. Pruritus 3. GI distress (high doses)
154
What is used for Vitamin K deficiency
Phytonadione
155
Phytonadione is synthesized by
GI normal flora
156
Indications for administration of phytonadione
1. Deficiency states 2. Warfarin excess (antidote)
157
Which route of Phytonadione may cause death
IV route
158
Phytonadione interfers with
Warfarin therapy
159
Vitamin K toxicity
1. Jaundice 2. Hyperbilirubinemia 3. Hemolytic anemia 4. Kernicterus in infants
160
Indications for thiamine administration
1. Beriberi 2. Wernicke-Korskoff's (alcoholic) encephalopathy 3. Peripheral neuritis 4. Deficiency and malnutriotion 5. ETOH 6. Malabsorption syndromes
161
List the minerals discussed
1. Calcium 2. Magnesium 3. Phosphorus 4. Potassium 5. Sodium
162
What is the action of calcium
1. Musculoskeletal, nerve, and cardiovascular function
163
What is the indication of calcium
1. Deficiency 2. Reduce risk of osteoporosis 3. Used in conjunction with Vitamin D to increase calcium absorption
164
What is the action of magnesium
1. Activates many intracellular enzymes; helps to regulate skeletal and cardiac muscle contractility
165
What are the indications of magnesium
1. Deficiency 2. Antacid or laxative 3. Decrease uterine contractions 4. Prevent seizures in preeclampsia
166
What are the risks of toxicity of magnesium
1. AV node conduction suppression 2. Muscle weakness 3. Respiratory depression 4. Diarrhea 5. ANTIDOTE: Calcium Gluconate
167
What is the action of phosphorus?
1. Regulates -Acid base balance -Bone formation -Energy production and storage -Hormone activation
168
What is the indication of phosphorus
1.Deficiency 2.May prevent some kidney stone formation
169
What is the action of potassium
1. Regulate -Acid-base balance -Nerve action potentials -Electrical excitability of muscles
170
What is the indication of potassium
1. Deficiency
171
What is the toxicity of potassium
1. EKG changes 2. Muscle cramps 3. Palpitations
172
What is included in the assessment of minerals
1. Obtain a nutritional assessment 2. Screen for any medical conditions and medications 3. Evaluate skin, mucous membranes, pulse, respirations, BP 4. Complete blood count (CBC), clotting times, basic metabolic panel(BMP), magnesium levels
173
What is included in the nursing diagnosis of minerals?
1. Impaired comfort related to GI discomfort 2. Malnutrition risk related to replacement therapy 3. Knowledge deficit regarding drug therapy
174
What is included in the implementation of minerals
1. Patients general physical condition 2. Advise patient to avoid use of OTC preparations that contain the same vitamins 3. Take with meals to alleviate GI distress 4. Patient teaching
175
What is included in the evaluation of minerals?
1. Response to supplement 2. Adverse effects 3. Effectiveness of teaching plan 4. Monitor the compliance with the regimen

Pharmacology (4 decks)

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