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13 Cards in this Set

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Polyuria
Excessive amount of glucose in blood causes kidneys to release more water, creating excessive diuresis
Polyphagia
Muscles don’t utilize glucose as well as they should, causing them to “starve”, so fat and protein reserves are used up; body responds by sending signals that it’s hungry
Polydipsia
Excessive thirst related to excessive diuresis
Sulfonylureas
Oral hypoglycemic, MOA: decrease blood glucose by stimulating pancreatic beta-cell production of insulin, increasing tissue sensitivity to insulin, decreasing glucose production by the liver, and increasing the number of cellular insulin receptors.
SE: N&V, skin and/or pulmonary reactions, hepatic and/or renal effects, aplastic anemia
Nursing Considerations: watch for hypoglycemia, do not used in sulfa allergies
Meglitinides
MOA: similar to sulfonylureas yet absorbed faster with minimal renal excretion.
Biguanides
Cellular sensitivity Also similar to sulfonylureas, but much greater incidence of renal toxicity. Raises creatinine and lactic acidosis. Not given anymore at St. John Health System.
Alpha Glucosidase Inhibitors
MOA: inhibits action of pancreatic alpha amylase and membrane-boiund intestinal glucoside hydrolase enzymes; this inhibition causes delay indigestion of Carbohydrates, slows absorption of glucose in the small intestine, and lowers HbA1C
SE: abd pain, flatulence, diarrhea
Thiazolidnediones (TZDs)
SE: headache, hepatotoxicity, fluid retention/CHF

Side note: “Thiazolidinediones or glitazones specifically target insulin resistance. They have proven efficacy for reducing plasma glucose levels of type 2 diabetic patients treated with diet alone, sulphonylureas, metformin or insulin. In addition, they may be associated to some improvement of cardiovascular risk profile.
Glucocorticoids
MOA:MIMIC THE FUNCTIONS OF CORTISOL= INTEGRATES COLLAGEN, INCREASE SCAR TISSUE FORMATION, INCREASE BREAK DOWN OF BONES, INCREASE METABOLSIM, GASTRIC SECRETION, GLUCONEGENIOUS, SODIUM RETENETION. SE: muscle weakness/myopathy, osteoporosis, bruisability, decreased wound healing (very thin, opaque skin), alteration in fat metabolism (dorsocervical fat pad/buffalo hump), fluid & lyte changes, ulcerogenic, increased IOP, CNS and psychiatric disturbances
Mineralocorticoids
MOA: mimics the functions of aldosterone (affecting fluid and lyte balance by acting on distal renal tubule to enhance sodium resorption and potassium and hydrogen excretion)
SE: sodium retention (hypernatremia, edema/CHF), hypokalemia, metabolic alkalosis, HTN, headache
Nursing considerations: Monitor blood pressure and signs of edema when patient is on chronic therapy; monitor serum electrolytes, serum renin, and blood pressure; monitor for evidence of infection
Thyroid Hormone Replacements
MOA: replaces thyroid hormones to maintain their normal functions; accelerates chemical reactions, O2 consumption, and heat production
SE: diarrhea, wt loss, abd cramps, increased appetite, palpitations, HTN, diaphoresis, tachycardia, headache, fever, tremor, heat intolerance, insomnia, menstrual irregularities, nervousness (all manifestations of hyperthyroidism), hypersensitivity
Nursing considerations: let patient know it takes 1-3 weeks for full effect, take daily in the AM on an empty stomach and with a glass of water. Lifetime medication
Thioamides/
PTU
MOA: decreases thyroxin production by inhibiting iodine, which is necessary for thyroxin formation. Inhibits thyroid hormone synthesis by blocking the combination of iodine and tyrosine. Inhibits conversion of T4 to T3.
--Graves' disease: an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). While a number of disorders may result in hyperthyroidism, Graves' disease is the most common cause.
SE: signs & symptoms of hypothyroidism, blood dyscrasias, skin rash, GI disturbances, headache, drowsiness
Nursing Considerations: delayed therapeutic onset
Iodides
MOA: In high doses, inhibits thyroid secretion of thyroxin & causes involution of thyroid gland. Gland actually shrinks because so much is given.
SE: same as PTU, metallic taste
Nursing considerations: peak drug concentrations in 10-15 days, warn patient about metallic taste, inform them of S/S of both hyper and hypothyroidis