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17 Cards in this Set
- Front
- Back
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DIABETES MELLITUS
GLUCOSE CONTROL l Increases Blood Glucose 3? l Decreases Blood Glucose 2? |
DIABETES MELLITUS
GLUCOSE CONTROL l Increases Blood Glucose • Glucose intake • Glucagon • Corticosteroids l Decreases Blood Glucose • Insulin • Oral hypoglycemic agents |
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INSULIN DEPENDENT DM
l Also known as: ? l Most severe form of?• Complications include ?l Decreased synthesis and release of insulin from pancreas |
INSULIN DEPENDENT DM
l Also known as: juvenile onset and Type 1 l Most severe form of DM • Complications include diabetic ketoacidosis l Decreased synthesis and release of insulin from pancreas |
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NON-INSULIN DEPENDENT DM
l Also known as ? l Usually ? l Functional beta cells in pancreas and/or decrease ?l No ? associated |
NON-INSULIN DEPENDENT DM
l Also known as Adult Onset DM and Type 2 DM l Usually overweight l Functional beta cells in pancreas and/or decrease sensitivity of peripheral cells to insulin l No ketoacidosis associated |
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Diabetes Melitus CONSEQUENCES
6 |
CONSEQUENCES
l Cardiac Disease l Renal Disease l Blindness l Peripheral Vascular Disease l Gangrene l Polyneuropathy |
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INSULINS
l Sources • 2? • Reactions: 2?• U-100 versus U-500 • Ultra-Short Acting: Lispro (Humalog®) • Short Acting: ?• Intermediate: ? • Long Acting: ? |
INSULINS
l Sources • Pork, Bio-genetic (Human) • Reactions: Lipodystrophy l Varieties • U-100 versus U-500 • Ultra-Short Acting: Lispro (Humalog®) • Short Acting: Regular, Semi-lente • Intermediate: NPH, Lente • Long Acting: Ultra-Lente, Glargine (Lantus®) |
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REGULAR INSULIN
l Onset: ? l Uses: • 2 • Intravenous: ?• Intravenous: ? • Only _____ insulin can be administered intravenously |
REGULAR INSULIN
l Onset: less than 1 hour l Uses: • Adjunct with longer acting-draw up in syringe first • Sliding Scale • Intravenous: Treat Ketoacidosis • Intravenous: Parenteral Nutrition • Only Regular insulin can be administered intravenously |
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INTERMEDIATE INSULINS
l Onset: ? l Duration: ? |
INTERMEDIATE INSULINS
l Onset: 2 hours l Duration: 24 hours |
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LONG ACTING INSULINS
l Onset: ? l Duration: ? |
LONG ACTING INSULINS
l Onset: 3 hours l Duration: 30 hours |
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INSULIN DOSE VARIABILITY
3 (2) |
INSULIN DOSE VARIABILITY
l Patient variability l Diet Compliance l Complications • Infection • Physical Stress (e.g. surgery) |
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TYPE 2 DM Therapy
2 (4) |
TYPE 2 DM Therapy
l Diet and Weight Loss l Oral Hypoglycemic Agents • Sulfonylureas • Biguanides • Thiazolidinediones • Miscellaneous |
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SULFONYLUREAS
l Increases ? production of insulin l First Generation ? l Second Generation • ? |
SULFONYLUREAS
l Increases Beta Cell production of insulin l First Generation • If one fails at maximum dose all will fail. Switch if side effects. l Second Generation • If one fails at maximum dose, others may be effective |
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SULFONYLUREA CONCERNS- 3
l Side effects • examples: 3?l Hypoglycemia l Cardiovascular abnormalities |
SULFONYLUREA CONCERNS
l Side effects • examples: tolbutamide - tinnitus, chlorpropamide - cholestatic jaundice l Hypoglycemia l Cardiovascular abnormalities |
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THIAZOLIDINDIONES
5 icluding 2 exs |
THIAZOLIDINDIONES
l Increases sensitivity of peripheral cells and hepatic cells to insulin l Deaths have been associated with troglitazone - liver failure l Associated with causing cardiac abnormalities l Not first line therapy l Examples: pioglitazone (Actos®), rosiglitazone (Avandia®) |
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THIAZOLIDINDIONES
l Increases sensitivity of ?(2)to insulin l Deaths have been associated with ?l Associated with causing ? l Not ? l Examples: 2 |
THIAZOLIDINDIONES
l Increases sensitivity of peripheral cells and hepatic cells to insulin l Deaths have been associated with troglitazone - liver failure l Associated with causing cardiac abnormalities l Not first line therapy l Examples: pioglitazone (Actos®), rosiglitazone (Avandia®) |
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TREATMENT OF HYPOGLYCEMIC REACTIONS
2 |
TREATMENT OF HYPOGLYCEMIC REACTIONS
l Glucose l Glucagon |
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l Diazoxide (Proglycem®) ?
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l Diazoxide (Proglycem®) - treatment for non-diabetics with chronic hypoglycemia
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DRUG CAUTION
l Beta Blockers - ? |
DRUG CAUTION
l Beta Blockers - block symptoms of hypoglycemia |
