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36 Cards in this Set
- Front
- Back
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Name 2 rapid acting human recombinant insulins:
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1)Insulin aspart or Novalog
2)Insulin Lispro or Humalog |
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What is one short acting regular human recombinant insulin?
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Humulin R or Novolin R or Velosulin VR
aka Regular Insulin |
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What are 2 intermediate acting NPH & Lente Human Recombinant Insulins?
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Insulin isophane suspension = NPH (Neutral Protamine Hagedorm)
Insulin Zinc Suspension = Lente Humulin N, Novolin N |
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What are 2 long acting Human Recombinant Insulins.
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Extended Insulin Zinc Suspension = Humulin U Ultralente
Insulin Glargine = Lantus |
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What 2 drugs are indicated in the treatment of hypoglycemia?
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Glucagon & Diazoxide
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What are signs and symptoms of hypoglycemia?
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weakness, nervousness, cold clammy skin, sweating, paleness, shallow rapid breathing, confusion, irritability. Later: tremors, hypothermia, seizures
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How long should insulin be stored at room temperature?
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1 month if it will be used. Otherwide refrigerated.
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When should Regular insulin and Lispro insulin be given in relation to meals?
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Regular - 30 to 60 minutes before meals
Lispro - 15 minutes before meals |
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Which insulins may be given with regular insulin?
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NPH 70%/reg 30%
or NPH 50%/Reg 50% |
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What are 3 types of pre-mixed insulins? (Hint: chart on p. 519).
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NPH Humulin 70/30
NPH 50/50 Lispro protamine suspension 75/lispro 25 (Humalog 75/25) |
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What are signs and symptoms of hyperglycemia?
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polyphagia, polyuria, polydipsia, blurred vision, fatigue, weight loss, poor wound healing, dry mouth, impotence, recurrent infections.
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What conditions impact blood glucose? (Hint: p. 531).
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illness, infection, vomiting, unable to eat, under stress.
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What is the MOA for : sulfonylureas
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Stimulates insulin secretion from the beta cells of the pancreas
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What is the MOA for : Prandin?
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meglitinide: stimulate the release of insulin from pancreatic beta cells
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What is the MOA for : Glucophage (Metformin)?
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biguanide: inhibits hepatic glucose production
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What is the MOA for Rosiglitazone (Avandia)?
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glitazone or thiazolidinedione derivative: decreases insulin resistance. May be used w/ sulfonylurea, metormin, or insulin
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Which oral anti-diabetic agents do not cause hypoglycemia?
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Biguanide metformin and alpha-glucosidase inhibitors (acarbose and miglitol)
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What instructions should the nurse give to patients Prandin and when to take it? How do these instructions differ from the Sulfonyureas and Metformin?
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Prandin given 30 minutes before breakfast. Dose is skipped if meal is skipped.
Sulfonyureas and Metformin are to be taken w/ breakfast to minimize mause or diarrhea |
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What instructions should the nurse give patients about how to inject insulin and rotate injection sites?
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draw clear insulin 1st
give insuling SubQ rotate sites w/in same location for 1 week before moving to new site. Inj s/b 1/2" to 1" away from previous injection |
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What laboratory value should be obtained before beginning and during treatment with glitazones?
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ALT liver function test for hepatic toxicity. Baseline and Q2Months for 1 year then periodically.
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What is the mechanism of action of thyroid agents?
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change metabolic rate, stimulate CV system, increase O2 consumption, body temp, blood volume, growth, & cellular growth
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What should patients be told about how long they will need to take thyroid medications?
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Taken for life unless stopped for radioactive isotope studies or MD order
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What are CV signs and symptoms of overdose in patients taking thyroid agents?
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dysrhythmia, tachycardia, palpitations, angina, HTN, cardiac arrest
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What is a natural thyroid medication?
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derived from cattle or hogs.
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When should patients take their thyroid medication? (Hint: p. 511)
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given at same time each day. best given in QAM to decrease liklihood of insomnia.
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What are 2 anti-thyroid agents and their mechanism of action?
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Methimazole and Propylthiouracil
MOA: inhibit incorporation of iodine into tyrosine, which is required to make thyroid hormone. Propyl inhibits conversion of thyroid precursors into thyriod hormone |
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What are 2 of the most damaging adverse effects of anti-thyroid medications?
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Liver and bone marrow toxicity
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What are geriatric considerations in patients taking anti-thyroid medications?
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>40 risk agranulocytosis.
don't eat foods high in iodine. agranolocytosis can occur if taken w/ bone marrow depressnts |
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What therapeutic changes should parents expect to see in children taking anti-thyroid medications?
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decreased pulse, return to normal B/P, decreased serum levels of T4 contraceptives
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What is the mechanism of action of the ECPs?
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inhibits ovulation, disrupts corpus luteum, decreases function of endometrial hormones.
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When should ECPs be taken?
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Within 72 hours of unprotected sex. afterwards, effectiveness declines to <85%
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A 25 year old female is prescribed an oral contraceptive. What drugs reduce the effectiveness of oral contraceptives (OCs)?
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anticonvulsants, beta-blockers, guanethidine, hypnotics, hypoglycemic agents, oral anticoagulants, theophylline, TCAs, Vitamins
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What are contraindications in the use of oral contraceptive agents?
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known drug allergies, pregnancy, Hx of thromboembolic events such as MI, venous thrombosis, PE, or stroke
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What is Depo-Provera
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Progestin injectable contraceptive give IM Q3 monthts
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What is a transdermal contraceptive
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fixed combo of estrogen and progestin. Applied weekly 3 weeks per month
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What is the intravaginal contraceptive?
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fixed combo of estrogen & progestin in ring. Insertied into vagina, kept in place 3 wks then removed for 1 week. new ring inserted after 1 week off for menses.
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