Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/14

Click to flip

14 Cards in this Set

  • Front
  • Back
Sulfonylurea
Glipizide (glucotrol)
Glipizide (glucotrol)

Indications
Control BS in type 2 DM

Actions Stimulate release of insulin from PANCREAS
Intermediate action

S.E. APLASTIC ANEMIA, wt gain, photosensitivity, hypoglycemia

NR. implications: Monitor s/s of hypoglycemia reaction,

Pt. Teaching: Take on an empty stomach (30 min before meal), Avoid aspirin and ETOH
Biguanide
Metformin (Glucophage)
Metformin (Glucophage)

Indications: Adjunctive management of type 2 diabetes

Actions: Decreases hepatic (liver) production of glucose Intermediate action

S.E. LACTIC ACIDOSIS, abd. Bloating, N, V, D

NR Implications:
Monitor s/s of hypo or hyperglycemia reaction, Stop day of surgery and 48Hp to px lactic acidosis. CONTRAINDICATED IN EXCESS ETOH/KIDNEY DYSFUNCTION, CHF, LIVER/RENAL DISEASE

Pt teaching
TAKE WITH MEALS
S/E of N, D, decreased appetite occurs in the 1-2 weeks.
Alpha-Glucosidase Inhibitors
Acarbose (Precose)
Acarbose (Precose)

Indications: Management type 2 DM w/ diet therapy
Inhibits enzyme alpha-glucosidase in GI tract INTESTINES
RAPID ACTION!!!!!!

S.E.
Abd. Pain, diarrhea, flatulence
NR Implications: Can be taken w/ other hypoglycemic agents or insulin. Observe s/s of hypoglycemia reaction.

Pt. Teaching
TAKE WITH 1ST BITE OF FOOD. IF HYPOGLYCEMIA OCCURS: TX WITH GLUCOSE, NOT SUGAR.
Thiazolidinedoines
Insulin Sensitizer
Rosiglitazone (Avandia)
Rosiglitazone (Avandia)

Indications: Adjunct to diet and exercise management in type 2 DM

Actions: Improves muscle cell sensitivity to insulin by acting as agonist (Decreases insulin resistance)

S.E. Liver toxic, edema, weight gain,

NR Implications:
Can be used with insulin, Observe s/s of hypoglycemia rx. MONITOR LIVER--check enzymes Q 2mo/yr.
DON'T USE WITH CHF

Pt. Teaching
Call dr. s/s of hepatic dysfunction (N, V, Abd. pain, fatigue, anorexia, dark urine, jaundice. Decrease oral contraception effectiveness, cause ovulation in premenopause.
Pancreatic Hormone
Lispro, Humalog
Very fast acting
Lispro, Humolog, very fast acting

Indications
tx type 1, management type 2 unresponsive to tx with diet oral meds

Actions
decreases blood sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to protein in muscle.

S.E. Hypoglycemia, anaphylaxis

NR implications
Onset 15 minutes. Peak 30-90 minutes. Duration 6-8 hours. Assess s/s hypo or hyperglycemia

Pt teaching
Clear insulin

All insulins: check expire date, no freeze/heat, store in fridge, but administer room temp.
Pancreatic Hormone
NPH, INTERMEDIATE ACTING
NPH INTERMEDIATE ACTING

Indications
Tx type 1, management of type 2 unresponsive to tx w/ diet oral meds.

Actions
Decreases blood sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to proteins in muscle.
S.E. Hypoglycemia, anaphylaxis

NR implications
Onset 2-4 hours. Peak 4-10 hours. Duration 10-16 hours. Assess s/s of hypo or hyperglycemia

Pt. Teaching
CLOUDY INSULIN, check for frosting/ crystals (don't use)
Pancreatic Hormone
Gargine (Lantis) Long acting Basal/BG
Gargine (Lantus)
Long Acting Basal/BG

Indications:
Tx type 1, management type 2
unresponsive to treatment with diet and oral meds

Actions:
Decreases blolod sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to proteins in muscle.

S.E.
Hypoglycemia, anaphylaxis

NR implications
Onset 2-4 hours Peakless. Duragion 20-24 hours
Assess s/s hypo or hyperglycemia

Pt. teaching
Never Mix with other insulins.
No IV
Clear insulin in tall/thin vials.
Always take same time of day within two hour window.
Hormones Pancreatics
glucagon
glucagon

Indications
Acute management of severe hypoglycemia when administration of glucose is not feasible.

Actions: stimulates hepatic production of glucose from glycogen stores (glycogenolysis)
Relaxes teh musculature of the GI tract (stomach, duodenum, small bowel, and colon), temporarily inhibiting movement.
Has positive inotropic and chronotropic effects.

S.E.
N/V anaphylaxis, transient increase in heart rate and blood pressure

Nr. Implications
Assess signs of hypoglycemia. Assess for nausea and vomiting. Assess neurologic status.

Pt. Teaching
Instruct family on correct technique to prepare, draw up, and administer injection. Teach patient and family s/s of hypoglycemia. Instruct pt to take oral glucose as soon as symptoms of hypoglycemia occur--glucagon is reserved for episodes when pt is unable to swallow
Endocrine
Corticosteroids Systemic Hormone replacement

Steroids (Solu-Medrol, Prednisone, Decadron)
Steroids (Solu-Medrol, Prednisone, Decadron)

Indications:
Used in wide variety of chronic diseases

Actions:
Suppress inflammation and normal immune response.

Side Effects:
PEPTIC ULCER, decreased wound healing, depression, HTN, osteoporosis, THROMBOEMBOLISM
NR Implications
Monitor I/O, wt daily, peripheral edema, rales/crackles, dyspnea

Pt. teaching: NEVER stop oral med independently--> adrenal insufficiency (anorexia, N, weak, fatigue, dyspnea, hypotension, hypoglycemia). Report infection immediately.
Thyroid Preparation/Hormone Replacement
Levothyroxine (Synthroid)
Levothyroxine (Synthroid)

Indications: Hypothyroidism

Actions: Increases metabolic rate, promote gluconeogensis, protein synthesis, cell growth, contain t3, t4 activity

NR. Implications
If too large dose: Monitor for CORONARY INSUFFICIENCY (chest pain, dyspnea, tachycardia). Assess if take anticoagulant or dig--bleed/dig toxic

Pt teaching:
TAKE LIFELONG-SAME TIME EVERY DAY 1 H BEFORE OR TWO HOURS AFTER MEAL WHEN MOST ACTIVE, do not switch to generic. Avoid excess foods inhibit TH-turnips
Anti-diuretic Hormone (ADH) Pituitary

Pitressin (Vasopressin)
Pitressin (Vasopressin)

Indications: Diabetes insipidus

Actions: Signals kidneys to retain H2O, returns it to vascular circulation. Inhibits urine production. High doses act as peripheral vasoconstrictor
S.E. MI, dizzy, abd. cramp, heartburn, pounding sensation in head

NR implications: Monitor ECG throughout therapy

pt teaching: Drink 1-2 glasses of H20 with med to minimize s/e (blanching of skin, abd. cramps, N) normally go away in few min.
Calcium Replacement

Calcium Gluconate
Tx and px of hypocalcemia

actions-Essential for nervous, muscular, skeletal, bone formationand blood coagulation

S.E. CARDIAC ARREST AND phlebitis (IV only) arrhythmias, constipation

NR Implications
Monitor BP, pulse, ECG throughout IV therapy. Can cause vasodilation (results in hypotension, bradycardia, arrhythmias, and cardiac arrest)

Pt. teaching
Avoid taking w/in 1-2 hours of other meds. Avoid large amounts of oxalic acid (spinach, rhubarb, phytic acid (brans, cereals, or phosphorus dairy products).
Sodium Iodine

Radioactive Iodine (RAI)
Indications: Adjunct with antithyroid drugs prior to surgery. Tx thyroid crisis

Actions: thyroid gland absorbs iodine, RAI destroys/damages cells so they produce less thyroid hormone.

S.E. D, Hypothyroidism

NR Implications:
CONTRAINDICATED IN PREGNANT WOMEN. CAN CAUSE HYPOTHYROIDISM. Assess for s/s metallic taste, stomatitis, skin lesions, severe GI upset.

Pt teaching
GIVE ONE ORAL DOSE EXCRETED IN TWO DAYS. PRECAUTIONS: FLUSH TOILET 2-3xs, INCLUDE FLUID INTAKE, USE SEPARATE UTENSILS, TOWELS, WASHCLOTH. RINSE SINK
Parathyroid Hormone
Calcitonin/Salmon
Calcitonin/Salmon
Indications; adjunctive therapy of hypercalcemia

Actions: Decreases serum calcium by direct effect on bone, kidney, and GI tract. Promotes renal excretion of Calcium

S.E. Anaphylaxis, N, V, inject site rx, facial flushing

NR Implications
Assess s/s hypersensitivity, on 1st few doses: watch for hypocalcemic tetany (nervous, irritable, muscle twitch, tenaic spasms, convulsions)
Call dr. if hyperglycemia reoccurs (deep bone/flank pain, renal calculi, anorexia, N/V, thirst, lethargy.