6 Murphy N305 Diabetes

Front 1

Drugs for Diabetes Mellitus:

Back 1

Let's first talk about the different types of Diabetes Mellitus

Front 2

What are some important facts about Type 1?

Back 2

Type 1 = Insulin dependent diabetes mellitus IDDM
- Destruction of pancreatic beta cells
– No insulin produced
– Typically begins in childhood
– Short-term complications include hypo/hyperglycemia, ketoacidosis (in hyperglycemia)

Front 3

What are some important facts about Type 2?

Back 3

Type 2 = non-insulin dependent diabetes mellitus NIDDM
-Insulin resistance
-Impaired insulin secretion
-More prevalent; typically involves obesity

Front 4

Long term complications include what?

Back 4

Long Term complications include: macrovascular disease (hypertension, stroke, heart disease), microvascular disease, nephropathy, neuropathy, amputations, impotence, gastroparesis, retinopathy

Front 5

What are goals of therapy for Diabetes?

Back 5

*Maintain glucose levels w/in an acceptable range
Take 1 oral hypoglycemic drug or 2 different oral drugs (Oral+insulin, insulin alone, insulin+ thiazolidindione)

-Make changes in one's lifestyle

Front 6

Types of Insulin:
Short-Duration: _____ Acting
LISPRO [Humalog] (AA switch)
Often taken with ______acting insulin

Back 6

Short-Duration: Rapid Acting
Lispro [Humalog] (AA switch)
Insulin aspart [NovoLog] (AA switch)
Often taken with longer acting insulin

Front 7

Short-Duration: Slower Acting
_______ (natural) insulin
Only form given __ (SC most common)

Back 7

Short-Duration: Slower Acting
REGULAR (natural) insulin
Only form given IV (SC most common)

Front 8

____________ Duration
Lente insulin (____-modified)
Neutral _________ Hagedorn (NPH) insulin

Back 8

Intermediate Duration
Lente insulin (zinc-modified)
Neutral Protamine Hagedorn (NPH) insulin

Front 9

Long Duration
Ultralente (zinc-modified)
Insulin ________ [Lantus] (AA switch)
Less risk of ____glycemia
Intermediate and ____ duration insulin have prolonged effects

Back 9

Long Duration
Ultralente (zinc-modified)
Insulin glargine [Lantus] (AA switch)
Less risk of hypoglycemia
Intermediate and long duration insulin have prolonged effects

Front 10

Insulin Administration:

Back 10

Specialized insulin syringes (U100) *Usually has an orange tip*

Front 11

Complications of Insulin Therapy

Tell about some Hypoglycemia and DDI issues:

Back 11

Hypoglycemia =
Low blood glucose (<50 mg/dl)
Insulin levels > Insulin demand
Treatment is by increasing blood sugar
Glucagon (opposite effects of insulin)

Front 12

Tell about some DDI issues:

Back 12

Hypoglycemic agents (drugs that lower glucose levels). Include sulfonylureas, meglitinides, beta-blockers, and alcohol
Beta-blockers may conceal

hypoglycemia
Hyperglycemic agents
Include TZDs, GCs, and sympathomimetics

Front 13

ORAL Hypoglycemics
Often for Type 2 diabetes

Back 13

One, Two, Three......
Three Drugs

Front 14

TOLBUTAMIDE [Orinase]
Class - Sulfonylureas
Stimulates release of insulin
For lean pts insulin deficient

Back 14

Tolbutamide [Orinase]

What is it's Class?

This drug is given to lean of obese pts who have diabetes?
(HInt: Assume that all tall people are lean people. TOLbutamide. This drug is for "Tall" people)

Front 15

Metformin [Glucophage]
Class - Biguanides
Decreases glucose production
SE = lactic acidosis
For obese pts insulin resistant
Possibly for NIDDM prevention

Back 15

Metformin [Glucophage]

What is it's class again?
Decreases _______ production

For lean of obese pts?
(Hint: BIGuanides & METformin. You MET a BIG person for this drug)

Front 16

ROZIGLITAZONE [Avandia]
Class - Thiazolidinediones (Glitazones)
Increase insulin sensitivity

Back 16

Rosiglitazone [Avandia]

What is it's class again?
This drug ______ insulin sensitivity

Front 17

Think about what these drugs do, what is a major Side effect for these drugs?

Back 17

hypoglycemia

Front 18

Nursing intervention:

How do you treat insulin deficiency?

Back 18

TREATMENT:
Insulin replacement
Bicarbonate for acidosis
Water and sodium replacement
Potassium replacement
Normalization of glucose levels

Front 19

In relation to diabetes,
what sort of diabetes can pregnant mothers get? It often appears during pregnancy and then rapidly subdues after birth.

Back 19

Gestational diabetes

Does pregnant mothers and diabetes make sense?

Front 20

This is the end of your Diabetes note-cards!

Back 20

Great Job!