Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
59 Cards in this Set
- Front
- Back
|
Type I diabetes
|
Insulin dependent- caused by an autoimmune destruction of the beta cells in the pancreas
|
|
|
Type II diabetes
|
Non insulin dependent- a decrease in beta cell activity
|
|
|
Gestational diabetes
|
Women who show abnormal glucose tolerance during preganancy
|
|
|
Prediabetes
|
Intermediate stage between normal glucose homeostasis and diabetes
|
|
|
Hyperglycemia
|
High blood glucose when the body has too little insulin or when the body can't use insulin properly
|
|
|
Neuropathies
|
First observed as numbness and tingling of the extremities,loss of sensation, orthostatic hypotension, impotence, or vaginal yeast infections, and difficulty in controlling urination
|
|
|
Hypoglycemia
|
Blood glucose level less than 60 mg/dl
|
|
|
Tests to diagnose diabetes
|
Fasting glucose test
Random blood glucose Hemoglobin |
|
|
Assessment
|
Thirst, urination frequent, shaking
Monitor vision Assess mentation Adaptation to disease Full history of diet |
|
|
Polyphagia
|
Too much eating
|
|
|
Polydipsia
|
Excessive thirst
|
|
|
Polyuria
|
Excessive urination
|
|
|
Insulins
|
A hormone produced in the beta cells of the pancreas
|
|
|
Onset
|
The time required for the medication to have an initial effect or action
|
|
|
Duration
|
How long the agent remains active in the body
|
|
|
Peak
|
When the agent will have the maximum effect
|
|
|
Rapid acting insulin
|
Novolog (aspart)- peak 1-3
Humalog (lispro)- peak 0.5-2.5 Apidra (glulisine)- peak 0.5-1.5 |
|
|
Short acting
|
Humulin R - peak 2.5-5
Novolin R- peak 2.5-5 |
|
|
Intermediate acting
|
Humulin N peak 4-12
Novolin N peak 4-12 |
|
|
Long acting
|
Lantus (glargine)- peak can be given anytime long effect
Levemir (detemir) |
|
|
Insulin
|
When open bottle of insulin put date on it to know when it will expire
Store it in refrigerator until used Once opened then can be stored at room temperature Advise patient to have spare bottle handy Encourage patient to alternate sites of injection |
|
|
Side effects
|
Allergic reaction- usually caused by biosynthetic insulin
Lipdystrophies- comes from hardening of the skin |
|
|
Insulin inhalation powder
|
Exebera- works by stimulating glucose uptake and inhibits glucose production in the liver
|
|
|
Uses
|
Type I- should be used with long acting insulins
If a smoker then do not use bec it causes constriction |
|
|
Biguanide
|
Metaformin (glucophage)
|
|
|
Actions
|
Prevents glycogenolysis and glucogenesis
May not be ideal for hepatitis patients |
|
|
Uses
|
Has effect on cholesterol
Should have checked often |
|
|
Side effects
|
Lactic acidosis- muscle weakness or pain
Build up of lactic acid in muscles 24 hrs before CT 48 hrs after CT Interacts with the dye used for CT scans Can put patient in renal failure Monitor alcohol intake and oral contraceptives |
|
|
Sulfonylurea
|
Glimepride (amaryl)
Glipizide (glucotrol) Glyburide (glynase) |
|
|
Actions
|
Stimulate the release of insulin from the beta cells of the pancreas
|
|
|
Uses
|
Type II
|
|
|
Side effects
|
Hepatotoxicity- enlarge liver, jaundice, vomit, nausea
|
|
|
Drug interactions
|
Alcohol-manifest themselves anatbuse like
|
|
|
Meglitinides
|
Repaglinide (prandin)
Nateglinine (starlix) |
|
|
Actions
|
Lower blood glucose by stimulating the release of insulin from beta cells
|
|
|
Uses
|
Type II
|
|
|
Drug interactions
|
Oral contraceptives and estrogens they can cause hyperglycemia
Hypoglycemia- if taken with another drug that lowers BG |
|
|
Thiazolideione oral agents (TZD)
|
Piolitazone (actos)
Rosiglitazone(avandia) |
|
|
Actions
|
Increasing the sensitivity of muscle and fat tissue to insulin
Makes it easier for glucose to come in |
|
|
Uses
|
Type II
|
|
|
Side effects
|
Weight gain and fluid retention edema and BP concern
Patient susceptible if taken with insulins and sulfonylurea to hypoglycemia Encourage not to discontinue |
|
|
Alpha glucosidase inhibitors
|
Acarbose (precose)
|
|
|
Actions
|
Inhibits pancreatic alpha amylase and GI alpha glycoside which is used in the digestion of sugars
|
|
|
Uses
|
Type II that is NOT controlled by diest and exercise
Fewer long term complications |
|
|
Outcome
|
More of a marathon long term drug
|
|
|
Side effects
|
Abdominal cramps- due to the metabolism of carbs in the large bowels
Flatulence- breaks off carbs then causes gas Hepatotoxicity- monitor liver function When given along with steroids and diuretics can decrease therapeutic effect which in turn can cause hyperglycemia |
|
|
Alpha glucosidase inhibitors
|
Miglitol (glyset)
|
|
|
Actions
|
Inhibits pancreatic alpha amylase and GI alpha glycoside which is used in the digestion of sugars
|
|
|
Uses
|
Type II NOT controlled by diet and exercise
|
|
|
Side effects
|
Abdominal cramps and flatulence
Hypoglycemia- when given with other diabetes meds |
|
|
Incretin-Mimetic agent
|
Exenatide (byetta)
|
|
|
Actions
|
Enhances insulin secretion
Delays gastric emptying Reduces appetite Maintain beta cell function (injections not tablet. Pseudo insulin) |
|
|
Uses
|
Reducing elevated blood glucose levels in type II DM who are taking metformin or sulfonylurea
|
|
|
Outcomes
|
Does the same as oral but just given subq
Fewer long term complications |
|
|
Drug interactions
|
When given with warfarin, coumadin, MAOI, anti diuretics watch for hypoglycemia
|
|
|
Antihypoglycemic agents
|
Glucagon
|
|
|
Actions
|
Needs presence of glycogen in order to be turned into glucose
|
|
|
Uses
|
Unresponsive patient- give glucagon given thru IV 50% sugar also in Tab form sit under tongue let it dissolve by itself
Most patient- have standing order do not call Dr. Usually not first choice Used in hypoglycemic reaction in DM patient |
|
|
Side effects
|
If unresponsive can still vomit
|
