N114 Pharm Diabetic Drugs

Front 1

6th Leading cause of death in the US

Back 1

Diabetes

Front 2

DMII is more prevalent in which 3 populations?

Back 2

Native American
Hispanic
African American

Front 3

Diabetes Mellitus is a disorder of the _______

Back 3

pancreas

Front 4

Diabetes Mellitus is a ____ disease as a result from deficient ____ ______

Back 4

chronic

glucose metabolism

Front 5

Diabetes Mellitus is caused by insufficient ___ secretion from ___ cells.

Back 5

insulin

beta

Front 6

The chronic hyperglycemia of diabetes is associated with long term ______ of various organs (especially the ___, _____, ____, ____, and ___ ____)

Back 6

damage

eyes, kidneys, nerves, heart, and blood vessels

Front 7

Pt must have functioning ___ ____ to take oral glucose

Back 7

beta cells

Front 8

Insulin Dependent diabetes

Back 8

Type I Diabetes

Front 9

NIDDM

Back 9

Non insulin dependent diabetes mellitus- Type II Diabetes

Front 10

Type I or Type II Diabetes? The Primary beta cell destruction leading to absolute dependency on insulin

Back 10

Type I

Front 11

Type I or Type II Diabetes? Most common Type. There is some beta cell function with varying amounts of insulin secretion. There can be insulin resistance of cells or a decreased number of insulin receptors on cells.

Back 11

Type II Diabetes

Front 12

"Juvenile Onset" Diabetes

Back 12

Type I

Front 13

Can people with Type I Diabetes take oral agents?

Back 13

No because they do not have functioning beta cells

Front 14

3 Causes of Type I Diabetes

Back 14

autoimmune, genetic, viral infections

Front 15

2 causes of Type 2 diabetes

Back 15

genetic, obesity

Front 16

Insulin dependent Diabetes

Back 16

Type II diabetes

Front 17

What Are The Symptoms Of Diabetes?

Back 17

The 3 P’s
Polyphagia, Polydypsia, Polyuria
(also fatigue, blurred vision, and N/V)

Front 18

acute complications arise from uncontrolled blood sugars: _______ and _______

Back 18

Hyperglycemia & Hypoglycemia

Front 19

Some acute complications require _________ medical attention.

Back 19

immediate

Front 20

acute complications that require immediate medical attention include: (3 things)

Back 20

1. Hypoglycemia
2. Hyperosmolar Nonketotic Coma (HONKC)
3. Diabetic Ketoacidosis (DKA)

Front 21

Chronic Complications
 Tend to arise over ____ or ______

Back 21

years

decades

Front 22

Complications from diabetes can affect the _____, _____ and ________.

Back 22

kidneys, heart and circulation

Front 23

How does diabetes damages kidneys

Back 23

Sugar molecules are huge so they rip through the fine mesh of the kidneys and cause damage

Front 24

How does diabetes affect the eyes?

Back 24

It is the leading cause of new cases of blindness

Front 25

Diabetes causes: (3 things)

Back 25

Retinopathy
Nephropathy
Neuropathy

Front 26

Too high blood sugar causes

Back 26

organ/tissue damage

Front 27

What is Hemoglobin A1c*

Back 27

Lab that monitors avg. glucose level for past *3 MONTHS*

Front 28

What is optimal Hemoglobin A1c* value/level?

Back 28

< 7.0%

Front 29

What is desired Before Meal Glucose Level?

Back 29

70-130 mg/dl

Front 30

What is desired After Meal Glucose Level?

Back 30

< 180 mg/dl

Front 31

prepramdial

Back 31

before meal blood sugar

Front 32

postpramdial

Back 32

after meal blood sugar

Front 33

Can insulin be administered orally?

Back 33

NO!!!!!!!!!!!!!

Front 34

___ agents work to improve the action of insulin or glucose.

Back 34

oral

Front 35

Oral Agents are not used for Type ____ diabetics

Back 35

Type I

Front 36

Insulin is produced normally by the islets of Langerhans ____ cells in the _______.

Back 36

beta

pancreas

Front 37

Insuli effects the production and storage of ______ by the liver.

Back 37

glycogen

Front 38

Insulin plays a key role in allowing the body to store and use carbohydrate, fat and protein. The action of insulin allows _____ in the blood to move into the ____ for energy.

Back 38

glucose

cells

Front 39

What is mealtime insulin?

Back 39

Short acting insulin (Regular insulin)

Front 40

What insulin stimulates natural insulin response to meal

Back 40

Rapid-acting insulin (Lispro)

Front 41

What insulin ins admin WITH a meal?

Back 41

Rapid-acting insulin (Lispro)

Front 42

Rapid-acting Insulin
 Absorbed more _____ than short-acting insulin, but effects wear off ______

Back 42

quickly

sooner

Front 43

what insulin is cloudy?

Back 43

Intermediate acting insulin (NPH)

Front 44

What insulin used for Between meal & overnight coverage?

Back 44

Intermediate-acting Insulin (NPH)

Front 45

What insulin is in a suspension and must be mixed before giving?

Back 45

Intermediate-acting Insulin (NPH)

Front 46

If NPH taken in morning, when does it peak?

Back 46

Around lunchtime

Front 47

What insulin takes the longest to work?

Back 47

Long-acting Insulin (Glargine, Lantus)

Front 48

Lantus is administered when?

Back 48

Q day

Front 49

Does long-acting Insulin (Glargine, Lantus) have a peak?

Back 49

No peak—steady state

Front 50

Can long-acting Insulin (Glargine, Lantus) be mixed?

Back 50

NO!!!!!!!!!!!!!

Front 51

Where is insulin administered to?

Back 51

The insulin is injected into the layer of fat (subcutaneous tissue) just under the skin.

Front 52

The plastic, disposable syringes currently are available in three sizes, and hold up to __, __ or ___ units of insulin.

Back 52

30, 50 or 100 units of insulin.

Front 53

The needles are fine (up to ___ gauge) with lengths ranging from 3/16th of an inch for infants, to ½ inch or more for adults.

Back 53

31 gauge

Front 54

s/s of hypoglycemia

Back 54

Shaky, Fast heart beat, sweating, dizzy, anxious, HUNGER, BLURRY VISION, weakness, fatigue, headache, irritable

Front 55

s/s of hyperglycemia

Back 55

Extreme thirst, frequent urination, dry skin, HUNGER, BLURRED VISION, nausea, drowsiness

Front 56

How to treat Hyperglycemia (3 things)

Back 56

Treat underlying cause
Direct insulin administration (IV)
More frequent blood glucose monitoring

Front 57

Insulin ______ be Administered Orally

Back 57

Cannot

Front 58

Does insulin require a 2 nurse check?

Back 58

YES!!!

Front 59

Do not mix insulins that differ in ___ or _____

Back 59

purity
origin

Front 60

5 SQ sites?

Back 60

back of arms, back fat, love handles, abdomen, front (anterior) thighs

Front 61

What type of syringe can insulin be admin with?

Back 61

ONLY IN SULIN SYRINGE!

Front 62

Insulins prototype drug?

Back 62

Regular Insulin

Front 63

Regular Insulin pharmacotherapeutics

Back 63

for all pts with DMI, and those with DM II that cannot control their BS. Admin SQ. Can be admin q day and as correctional therapy.

Front 64

Regular Insulin pharmacokinetics

Back 64

Cannot be given orally, destroyed by gastric acids. SQ= slow steady absorption. Fastest route= ab.

Front 65

Regular Insulin pharmacodymanics

Back 65

facilitates membrane transport of glucose into cells. Mimics the effects of naturally produced insulin. Helps to maintain a constant level of body glucose.

Front 66

Regular Insulin most common adverse effects

Back 66

hypoglycemia

Front 67

Regular Insulin most serious adverse effects

Back 67

anaphylaxis and hypersensitivity

Front 68

Regular Insulin patient teaching

Back 68

dosage, admin, diet, exercise, BS testing

Front 69

OAs are not used for Type I diabetes because...

Back 69

They do not have functioning beta cells

Front 70

Short acting insulin Prototype?

Back 70

regular insulin

Front 71

Short Acting Regular insulin Onset, Peak, Duration?

Back 71

O: 30-60 min
P: 2-4 hrs
D: 5-7 hrs

Front 72

Rapid Acting Insulin drug names?

Back 72

aspart and lispro

Front 73

Aspart Onset, Peak, and Duration?

Back 73

O: 10-20 min.
P: 1-3 hr.
D: 3-5 hr.

Front 74

Lispro Onset, Peak, and Duration?

Back 74

O: w/in 15 min.
P: 1-1.5 hr.
D: 3-4 hr.

Front 75

Intermediate acting Insulin drug name?

Back 75

NPH

Front 76

NPH Onset, Peak, and Duration?

Back 76

O: 1-2 hrs
P: 4-12 hrs
D: 8-24 hrs

Front 77

long Acting Insulin drug name?

Back 77

glargine

Front 78

glargine Onset, Peak, and Duration?

Back 78

O: 3-4 hrs
P: none
D: 24 hr

Front 79

Non Insulin SDiabetics- sulfonylureas prototype drug?

Back 79

glyburide

Front 80

sulfonylureas (gyburide) pharmacotherapeutics

Back 80

adjunct treatment to lower blood glucose levels in pts with DM II. Combo with insulin.

Front 81

sulfonylureas (gyburide) pharmacokinetics

Back 81

Admin orally, absorbed in GI. Metab by liver.

Front 82

sulfonylureas (gyburide) pharmacodynamics

Back 82

hypoglycemic action d/t stimulation of pancreatic beta cells which causes increased insulin secretion. Ineffective in DMI pts.

Front 83

sulfonylureas (gyburide) most common a/e

Back 83

nausea, epigastric fullness, heartburn

Front 84

sulfonylureas (gyburide) most serious a/e

Back 84

hypoglycemia

Front 85

pt teachings for sulfonylureas (gyburide)

Back 85

out of control sugar signs and symptoms and dietary restrictions for BG levels and weight loss

Front 86

Ogther second-generation sulfonylureas drug name?

Back 86

glipizide

Front 87

Non insulin antidiabetics nonsulfonylureas- Biguanides prototype drug?

Back 87

metformin

Front 88

Biguanides (metformin) pharmacotherapeutics

Back 88

used as an adjunct to diet and exercise to lower BG in DM II, and is usually the first choice drugs for DM II.

Front 89

Biguanides (metformin) pharmacokinetics

Back 89

taken as an oral tablet, absorbed in GI

Front 90

Biguanides (metformin) pharmacodynamics

Back 90

decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and use in skeletal muscle and adipose tissue through increased transport of glucose across the cell membrane

Front 91

Biguanides (metformin) most common a/e

Back 91

nausea, diarrhea, abdominal bloating, flatulance, and anorexia

Front 92

Biguanides (metformin) most serious a/e

Back 92

lactic acidosis and hypoglycemia

Front 93

Non insulin antidiabetics nonsulfonylureas- Alpha-glucosidase inhibitor drug name?

Back 93

acarbose

Front 94

Alpha-glucosidase inhibitor (acarbose) pharmacodynamics

Back 94

for slow down enzymes needed to digest carbohydrates in the brush boarder cells of the small intestine. Effectively lowering postprandial serum glucose.

Front 95

Non insulin antidiabetics nonsulfonylureas- Incretin Mimetic drug name?

Back 95

exenatide

Front 96

Incretin Mimetic (exenatide) pharmacodynamics

Back 96

mimics the actions on incretin hormones, lowers BG levels, helping them to return to normal.Work at the glucagon-like peptide-1 receptors and produces effects similar to that of glucagon-like peptide-1.

Front 97

Glucose elevating agents prototype drug?

Back 97

Glucagon

Front 98

Glucagon pharmacotherapeutics

Back 98

used in unconscoius patients with diabetes to reverse the servere hypoglycemia resulting from insulin overdosage.

Front 99

Glucagon pharmacodynamics

Back 99

Increases BG levels by stimulating glycogenolysis in the peripheral tissues- increases BG levels

Front 100

Glucagon most common s/e

Back 100

nausea, vomiting, generalized allergic rxns including urticaria, respiratory distress, and hypotension.

Front 101

Glucagon most serious s/e

Back 101

hypokalemia

Front 102

Type I or Type II Diabetes? Most common Type. There is some beta cell function with varying amounts of insulin secretion. There can be insulin resistance of cells or a decreased number of insulin receptors on cells.

Back 102

Type II Diabetes

Front 103

"Juvenile Onset" Diabetes

Back 103

Type I

Front 104

Can people with Type I Diabetes take oral agents?

Back 104

No because they do not have functioning beta cells

Front 105

3 Causes of Type I Diabetes

Back 105

autoimmune, genetic, viral infections

Front 106

2 causes of Type 2 diabetes

Back 106

genetic, obesity

Front 107

Insulin dependent Diabetes

Back 107

Type II diabetes

Front 108

What Are The Symptoms Of Diabetes?

Back 108

The 3 P’s
Polyphagia, Polydypsia, Polyuria
(also fatigue, blurred vision, and N/V)

Front 109

acute complications arise from uncontrolled blood sugars: _______ and _______

Back 109

Hyperglycemia & Hypoglycemia

Front 110

Some acute complications require _________ medical attention.

Back 110

immediate

Front 111

acute complications that require immediate medical attention include: (3 things)

Back 111

Hypoglycemia
Hyperosmolar Nonketotic Coma (HONKC)
Diabetic Ketoacidosis (DKA)