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;
76 Cards in this Set
- Front
- Back
|
What type of effect does insulin have?
|
hypoglycemic effect
|
|
|
What are modified forms of insulin called?
|
Human analogs
|
|
|
S/S of hypoglycemia effect?
|
Early s/s
Tachycardia Confusion Irritabillity Diaphoresis Late s/s Hypothermia Seizures Coma death |
|
|
Alpha cells secrete what?
|
Glucogan
|
|
|
Beta cells secrete what?
|
Insulin
|
|
|
The lowering of PH of the blood from ketoacids which may progress to death if untreated.
|
Diabetic ketoacidosis (DKA)
|
|
|
Effect caused by glucogon (opp. of insulin) Which causes blood glucose to rise. Alpha cells secrete glucagon
|
Hyperglycemic effect
|
|
|
Effect caused by insulin whose presence causes glucose to leave the blood and serum glucose to fall. Beta cells secrete insulin.
|
Hypoglycemic effect
|
|
|
Acidic waste product of lipid metabolism that lowers the PH of the blood
|
Ketoacids
|
|
|
Rapid decrease in blood sugar usually during the night, which stimulates the release of hormones that elevate blood glucose(epi,cortisol and glucagon) resulting in an elevated morning blood glucose level.
|
Somogyi Phenomenon
|
|
|
Causes of Type I DM
|
Lack of insulin production
Production of defective insulin |
|
|
Drugs that cause hypoglycemia?
|
alcohol, phenytoin (dilatin), beta blockers, ACE inhibitors, Zoloft, ASA products
|
|
|
S/S of hyperglycemia?
|
3 P's
Polyuria Polydipsia Polyphagia Unexplained wt loss Fatigue Hyperglycemia Glycosuria |
|
|
Drugs that cause hyperglycemia?
|
Epinephrine, thyroid hormone, growth hormone, corticosteroids, thiazides, estrogen
|
|
|
What are the types of insulin?
|
Rapid
Short acting Intermediate Long acting Very long acting Premixed |
|
|
What is the purpose of insulin?
|
Restores the diabetic pt's ability to metabolize CHO,PRO, LIPIDS
Store glucose in the liver Convert glycogen to fat stores |
|
|
Causes of type I DM?
|
Auto immune
Environmental factors Genetics |
|
|
S/S of Type I?
|
Fruity breath, 3 P's wt loss, tiredness, glycosuria
|
|
|
Complications of Type I?
|
Poor circulation, cardio vasc complications, kidney problems, retinopathy, neuropathy
|
|
|
What are the Rapid-Acting (no letters after) Insulins?
|
HumaLog, Apidra & NovoLog
|
|
|
What are the Regular insulin(short acting)?
|
Humulin R, Novolin R (only one given IV ) clear
|
|
|
What are the Intermediate-Acting?
|
NPH & Lente-cloudy
|
|
|
What are the Long Acting?
|
Ultra-Lente 1 injection a day w/ regular insulin a/c
|
|
|
What are the Very Long Acting ?
|
Glarline Lantus-think gargantuous! Can not be mixed with any other insulin or solution
|
|
|
Insulin Mixtures?
|
Humalog Mix 50/50, Humulin 50/50, Humulin 70/30, Novolin 70/30, Novolog Mix 70/30 – these are NPH & Regular premixed together
|
|
|
What is the only insulin that can be given IV?
|
REGULAR
|
|
|
What is the onset of Lispro (humalog)?
|
5-15 min
|
|
|
What is the duration of Lispro (humalog)?
|
2-3 hrs
|
|
|
What is the peak of Lispro (humalog)?
|
30-75min
|
|
|
What is the onset of Aspart (novolog)?
|
10-20 min
|
|
|
What is the peak of Novolog (Aspart)?
|
1-3 hrs
|
|
|
What is the duration of Novolog (Aspart)?
|
3-5 hrs
|
|
|
What type of insulin is Aspart (Novolog)?
|
Rapid acting
|
|
|
What type of insulin is Humalog ( Lispro)?
|
Rapid
|
|
|
What type of insulin is Regular (R)?
|
Short acting
|
|
|
What is the onset of Regular?
|
Onset – 30 min
|
|
|
What is the peak of Regular?
|
Peak 2 to 5 hr
|
|
|
What is the duration of Regular?
|
Duration – 5 to 8 hrs
|
|
|
What type of insulin is NPH?
|
Intermediate
|
|
|
What type of insulin is Lente?
|
Intermediate
|
|
|
What type of insulin is NPH & Regular Mixed?
|
Premixed
|
|
|
Islets of Langerhans are?
|
Clusters of cells in the pancreas which are responsible for its endocrine function, the secretion of glucagon & insulin. Alpha cells secrete glucagons and beta cells secrete insulin.
|
|
|
Ketoacids are?
|
acidic waste product of lipid metabolism that lowers the pH of the blood.
|
|
|
Type 1 diabetes mellitus is?
|
Most common disease of childhood, accounting for 10% of all cases of DM. This results from autoimmune destruction of pancreatic beta cells, causing an absolute lack of insulin secretion
|
|
|
Type 2 diabetes mellitus is?
|
Clients can secrete insulin, although in deficient amounts. Insulin receptors in the target tissues have become insensitive to the hormone – insulin resistance. Proper diet & exercise can sometimes increase the sensitivity insulin receptors where drug therapy is unnecessary.
|
|
|
Hyperosmolar nonketotic coma (HNKC) is?
|
A life-threatening emergency in type 2 DM which develops slowly and is caused by insufficient circulating insulin.
|
|
|
Exocrine?
|
The exocrine function of the pancreas is the chemical digestion of nutrients
|
|
|
Diabetic Ketoacidosis (DKA) is?
|
The lowering of the pH of the blood from ketoacids which may progress to coma and possible death if untreated.
|
|
|
What oral hypoglycemic do you hold b4 any procedure where iodine contrast is used?
|
Biguanides
|
|
|
First generation oral hypoglycemic?
|
Sulfonylureas
|
|
|
Secong generation oral hypoglycemic?
|
Glipizide
suffix ide |
|
|
A/E when drinking alcohol w/ Sulfonylureas?
|
flushing, palpitations and nausea
|
|
|
S/E for Glucotrol?
|
severe hypoglycemia, wt gain, GI distress, HEPATOTOXCITY, dnt drink etoh
|
|
|
Sulfonylureas 1st gen drug?
|
Tolbutamide (orinase)
|
|
|
Sulfonylureas 2nd gen drug?
|
Glipizide (Glucotrol)
|
|
|
MOA of Sulfonylureas?
|
Simulates release of insulin from ilslet cells and increases sensitivity of insulin on target cells
|
|
|
SE/AE effect of Sulfonyreas?
|
Hypoglycemia, severe weight gain, GI Distress, Toxic to the liver
|
|
|
Biguanides name?
|
Metformin or Glucophage
|
|
|
MOA of glucophage or metformin?
|
Decrease hepatic production of the glucose and reduce insulin resistance in liver, does not cause weight gain or hypoglycemia
|
|
|
SE/AE of glucophage?
|
Anorexia or NVD
|
|
|
****Important instructions for glucophage before a procedure----
|
Hold metformin before up to 1 week and after about 48 hours any procedure where iodine contrast is used!
|
|
|
Alpha-glucosidase inhibitors
|
acarbose (Precose) or Miglitol (Glyset)
|
|
|
MOA of Alpha Glucosidase Inhibitors (Precose or Glyset)
|
blocks enzymes in small instestines to prevent break downs complex carbs into monsaccrides
|
|
|
SE/AE of precose or glyset
|
minimal flatus, abd cramping, nausea
|
|
|
Nursing considerations for precose or glyset
|
Monitor LFT
Garlic and Ginseng non, causes profound Hypoglycemia |
|
|
Thiazolidinediones med?
|
Actos or Avandia
|
|
|
MOA of Actos or Avandia
|
Decrease insulin resistance by inhibiting the liver, does not cause hypoglycemia
|
|
|
S/E for Actos or Avandia
|
Weight gain, HA, Fluid retention
|
|
|
Nursing Considerations for Actos or Avandia
|
Monitor LFT
|
|
|
Meglitinides drug?
|
Starlix or Prandin
|
|
|
MOA for Starlix or Prandin
|
Stimulates the release of insulin from pancreatic cells, works the same as sulfonyreas.
|
|
|
Newer agents for Type II
|
Byetta and Januvia
|
|
|
MOA for Byetta
|
Injectable for Type II, inhibits effects encretins hormones secreted by intestines followed by meals, increase in blood glucose
|
|
|
SE of Byetta
|
NVD
|
|
|
MOA of Januvia
|
works to DD4 inhibit or break down causes encretins not to be broken down
|
|
|
Nursing Considerations for Type II drugs
|
monitor for ketones
LFT monitor I & O any hormone secretions issue |
