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41 Cards in this Set
- Front
- Back
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Diabetes Mellitus |
Blood sugar is too high
chronic disease affecting 8 % of population
6th leading cause of death |
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Of those who have DM |
5-10% have type 1 (always receive insulin) 90-95% have type 2 |
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How is DM diagnosed |
blood tests - fasting blood sugar test or a random blood sugar test
hemoglobin A1c test - reveals average blood sugar levels for the past 2-3 months
glucose tolerance test |
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Type 1 DM |
normally body's immune system fights off foreign invaders, but in people with type 1 the immune system attacks various cells in the body
symptoms usually develop quickly and are caused by blood sugar levels rising above the normal range (autoimmune) |
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Type 2 DM |
pancreas does not make enough insulin or the body cannot use the insulin well enough (insulin resistant)
risk factors: - over 45 years -obesity - history of gestational diabates - family history of type 2 diabetes -pre-diabetes - no exercise, - low HDL cholesterol or high triglycerides - high BP - members of certain racial or ethnic groups |
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metabolic syndrome |
increased risk for developing type 2
- central ovesity - increased serum tryglycerides - decreased HDL - Htn - PFG > 100 mg/dl |
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3 symptoms of diabetes |
polyuria - frequent urination
polydipsia - excessive thirst
polyphagia - excessive hunger |
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Meds for different types |
all patients with type 1 require insulin
patients taking oral meds have type 2
sometimes type 2 takes both |
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Symptoms of DM |
- thirsty - dry mouth - fruity breath - frequent urination - unintentional weight loss - increased appetite - lack of energy |
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Ketoacidosis |
without treatment, type 1 deprives body's cells of the sugar they need for energy. body starts buring fat for energy instead which causes ketones to build up in body. These are acids that can poison the body and high levels can trigger a coma called diabetic ketoacidosis |
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Hyperosmolor non-ketotic diabetic coma |
person with type 2 becomes very ill or dehydrates and is not able to drink enough fluids to make up for the fluid losses |
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Insulin reaction |
too much insulin can lower blood sugar to dangerous levels (hypoglycemia)
warning signs: - exhaustion or excessive yawning - being unable to speak or think clearly - loss of muscle coordination - sweating, twitching, tunring pale - seizures - loss of consciousness |
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Insulin Pump |
needles changed q 3 days
device provides insulin around the clock, eliminating the need for insulin injections |
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Insulin reaction |
too much insulin can lower blood sugar to dangerous levels (hypoglycemia)
warning signs: - exhaustion or excessive yawning - being unable to speak or think clearly - loss of muscle coordination - sweating, twitching, turning pale - seizures - loss of consciousness |
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Somogyi phenomenon |
rapid decrease in blood sugar, usually at nights, stimulates release of hormones that elevate BS |
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Most frequent cause of death in the U.S.
Most common CVD
affects...
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Disease of the heart and vessels
hypertension
affects 1 in 3 people |
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What is linked in evidence based practices about CVD |
above normal BP is linked to increased risk of CVD disease and kidney failure |
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Pre-Hypertension |
120-139
80-89 |
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Stage 1 Hypertension |
140-159
90-99 |
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Stage 2 Hypertension |
greater than 160
greater than 100 |
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Hypertensive crisis |
greater than 210
diagnosis is made after 2 readings on separate clinical visits |
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Systemic and local hypertension |
Systemic - measurement of arterial blood pressure (most common)
Local - portal (liver) often related to cirrhosis of the liver, pulmonary or left sided heart failure |
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Primary and Secondary Hypertension |
Primary - no specific cause is identified
Secondary - a specific cause is identified (medication, disease process) |
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Diseases associated with Hypertension |
- cushing's syndrome - hyperthyroidism - chronic renal impairement - arteriosclerosis - pheochomocytoma |
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Medications associated with hypertension |
- corticosteriods - oral contraceptives - erythroprotein - colloid solutions |
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Preload, afterload, contracility, blood volume, peripheral resistance |
Preload - blood going in, initial stretching -LVED (left ventricular end diastolic volume) -determinate of BP and cardiac output
Afterload - how much does the heart have to push against to get blood out (the load the heart must eject blood against) - wall tension in the left ventriclue during systole
Contractility - strength of the hearts contraction during systole
Blood volume - the amount of blood in the body, typically 5 L
Peripheral resistance - resistance of arteries to blood flow
afterload can never be more than preload
increased pressure = increased afterload and vice versa
diuretic = decreased Bp due to low volume (pee alot) |
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Body mass Index
Normal, overweight, obese |
18.5 to 24.9: Normal Weight 25 to 29.9: Overweight 30 and above: obese |
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Diuretics |
often drug of first choice in treating mild to moderate hypertension
works by decreasing circulating blood volume via the renal system
often used in combination with other antihypertensives |
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Ca+ channel blockers |
works by decreasing contractility, decreasing peripheral arterial resistance which leads to decreased BP |
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All anti-hypertensive medications put people at risk for |
orthostatic hypertension |
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ACE inhibitors |
inhibit the enzyme required for conversion of angiotensin 1-2
generic name ends in pril |
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ARB |
ARB - angiotensin receptor blocker
blocs the effects of angiotensin after it is formed
generic name ends in sartan
losartan (Cozaar)
route - PO preg category C for 1st trimester, D for 2nd and 3rd trimesters
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Beta Adrenergic antagonists |
works by blocking adrenergic receptors in the sympathetic NS, blocks flight or fight response
metoprololo
labetalol |
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Metoprolol (lolpresor) |
class - selective beta blocker (beta 1)
use - Htn, angina, CHF, Mi prevention
MOA - slectively blocks beta 1, slows HR, decreases contractility
ADR - bradycardia, hypotension and fatigue, beta blocker blues
Hold dose if pulse is less than 60 |
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Dementia |
clinical syndrome of progressive, degenerative loss of memory and one or more of these abilities: - language skills - higher level skills such as judgement - ability to recognize objects - ability to perform motor skills |
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Alzheimer's disease |
most common cause of dementia > 65 years
no cure
life expectancy is 8-10 years after onset of symptoms
goal to slow progression of disease, maintain ability to complete ADLs |
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Rivastigmine (exelon) |
alzheimers drug
MOA - decreases breakdown of acetycholine thus increasing the amount of neurotransmitter acetocholine in hte breain. and this increase compensates for loss of cholinergic function of the brain
thought to improve cognitive function by permitting more acetylcholine in the neuron receptors
PO and transmdermal |
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Rheumatoid arthritis RA |
RA is a systemic inflammatory disease
the effects are not limited to joint destruction
effects all age groups
thought to be autoimmune disorder
primary characteristic is symmetric multi-joint inflammation
can also cause inflammation of glands, linings of the heart, and lungs |
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Treatment of RA |
disease modifying anti rheumetic drugs (DMARD) are used alone or in conjucture with salicylats and NSAIDS
capable of arresting the progession of RA and can cause remission in some patients
methotrexate |
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Methotrexate (rheumatrex) |
RA drug,
slows progression of RA via immunosuppresant properties
MOA - inhibits the replication and function of T-lymphocytes that stimulate the production of cytokines especially interleukins
can cause bone marrow supression, immunosupression,
preg cat X
avoid alcohol, no echinacea, and limit intake of caffeine |
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Adjuvant medications |
increase efficacy of narcotics or provide independent analgesia |
