Pharmacology - Endocrine Drugs 1 -Olol

Front 1

Pancreatic Hormones

Back 1

insulin and glucagon

Front 2

Secretion of insulin and glucagon

Back 2

is controlled by the body's blood glucose levels

Front 3

Insulin - secretion

Back 3

secreted by beta cells in the pancreas called the islets of langerhans

Front 4

Insulin - promotes

Back 4

the transport of blood glucose into cells and the storage of glucose in the liver

Front 5

Glucose is

Back 5

energy or fuel for cells

Front 6

Insulin - inhibits

Back 6

glyconeogenesis (formation of new glucose from fatty acids and amino acids) and glycogenolysis (breakdown of glycogen into glucose) in the liver

Front 7

Glucagon

Back 7

secreted by the alpha cells in the islets of langerhans

Front 8

Glucagon promotes

Back 8

glycogenolysis (breakdown of glycogen into glucose) - increases blood glucose levels

Front 9

Insulin - works

Back 9

insulin secretion or administration is a decrease in blood glucose levels

Front 10

Blood Glucose levels

Back 10

normal - 70-100 mg/dl
above 110mg-dl insulin secretion increases
below 70 mg/dl glucagon secretion increases

Front 11

Prevention of Hyperglycemia

Prevention of Hypoglycemia

Back 11

Proper secretion of insulin

Proper secretion of glucagon

Front 12

Diabetes Mellitus

Back 12

destroyed pancreatic beta cells
caused by genetic and enviromental factors which cause an anti-immune response
results in decreased insulin production and resultant hyperglycemia
involves insulin resistance at the cellular level

Front 13

Diabetes Mellitus disease

Back 13

Chronic, systemic disease characterized by metabolic and vascular abnormalities- if caused by weight gain can sometimes be controlled by weight loss

Front 14

Diabetes Mellitus - Type I

Back 14

Juvenile, early onset, insulin dependent diabetes - must have insulin admin. Usually before age 20 - has sudden onset, 10% of all diabetics have type I

Front 15

Diabetes Mellitus - Type 2

Back 15

Adult onset, non-insulin dependent - patients usually overweight or obese, over 40 yrs old and have gradual onset of symptions - pancreas still produces some insulin, may be controlled with diet and oral agents, 90% of all diabetics

Front 16

Human source of insulin

Back 16

E.coli insulin is genetically altered (Humulin)

Front 17

Facts about Insulin

Back 17

Insulin is not effective when taken orally because it is destroyed in GI tract
metabolized in the liver, kidneys and muscle tissue
usually given SQ by injection or insulin pump

Front 18

Concentrations of Insulin

Back 18

almost always U-100 syringe
100 units per mil
use a syringe that corresponds to the vial concentration

Front 19

Storage of Insulin

Back 19

refrigerate unopened vials
can store opened vials at room temp. Only Lispro must be used in 28 days, rest of meds can go to expiration date

Front 20

Types of Insulin

Back 20

Regular - Humulin R or Novolin R
Rapid acting- lispro (Humalog)
Intermediate Acting (NPH) - Novolin N or Humulin N
Long acting Insulin - insulin zinc
Long acting - Lantus (insulin glargine)
Inhaled Insulin
Insulin Mixtures

Front 21

Regular

Back 21

rapid acting, Humulin R or Novolin R - onset- 30 min. to 1 hr - Peak 2 to 4 hrs -
Duration - 5 to 7 hrs -
meant to cover 1 meal
Only regular insulin can be given IV
only regular insulin used in hyperglycemic emergencies (DKA)

Front 22

Sliding Scale

Back 22

0-200= 0 units
201-250 = 2 units
251-300 = 4 units
over 300 = call
b4 admin. insulin ask whether the patient will be eating their next meal

Front 23

Questions to ask before administring insulin

Back 23

When is their next meal?
Are they NPO for a test?
Are they complaining of nausea?

Front 24

Rapid acting lispro (Humalog)

Back 24

most similar to physiologic insulin secretion after a meal and causes less hypoglycemia - most rapid acting - onset 15 min. - peak 30-90 min - duration 5 hrs

Front 25

lispro

Back 25

patients must eat within 15 min of lispro administration - works fast so be careful giving this med.

Front 26

NPH - intermediate acting (longer acting)

Back 26

Novolin N and Humulin N - onset 1-2 hrs - peak 8-12 hrs - duration 18-24 hrs
Will be CLOUDY looking

Front 27

Long acting Insulin Zinc

Back 27

Insulin Zinc - not popular drug - onset 4-8 hrs = peak 10-30 hrs - duration 36 or more hours

Front 28

Long-acting Insulin glargine

Back 28

Lantus - -short-acting with long acting effect -
forms microprecipitates subcutaneously and has sustained release actions
DO NOT GIVE with other insulins - Usually admin. SQ at bedtime- begins working 1 hrs and last for 24 hrs - NO PEAKING because sustained release

Front 29

Inhaled Insulin

Back 29

only used with adults and cannot have lung disorders - adm. 10 min prior to the meal - onset 15 min - peak 30-90 min Duration 4-6 hrs - may cause hypoglycemia

Front 30

Insulin Mixtures

Back 30

Humulin 70/30 or Novolin 70/30 Humulin 50/50- 70 units intermediate (NPH) and 30 units of rapid-acting (R)