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64 Cards in this Set
- Front
- Back
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The ________ system regulates other body system and facilitates homeostasis in the body.
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endocrine
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In the endocrine system, _______ are released directly into the bloodstream and travel to _______ _______.
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Hormones
Target organs |
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In contrast to the nervous system, hormones have a ____ onset of action and a _______ duration of action
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slower
longer |
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The master gland of the endocrine system is the _____ ________.
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Pituitary gland
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All hormone secretion is regulated by a _____ ______ _______.
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Negative feedback mechanism
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Disorders of the endocrine system can result from ______ and ________
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hypofunction
hyperfunction |
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The pancreas is both an ________ and _______ gland. It is the _______ gland in the body that has both functions
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endocrine
exocrine only |
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The ______ portion of the pancreas comprises only about 5% of the body of the gland.
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endocrine
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In the pancreas, the Islets of Langerhans is composed of _____ cells that produce ______, and _______ cells that produce _______.
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alpha-glucagon
beta-insulin |
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Glucagon and Insulin are released _____ into the bloodstream
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directly
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Insulin facilitates the transport of _____ in the cells where it can be used for energy
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glucose
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_________ ________ is a genetically influenced metabolic disorder of carbohydrate, fat and protein metabolism.
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Diabetes mellitus
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Diabetes mellitus is characterized by ________ ________ _____ _____ levels resulting from inadequate or absent _____ production and or impaired insulin _______.
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abnormally high blood glucose
insulin action |
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There are 2 types of diabetes mellitus:
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Type I
Type II |
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DM type 1 problem
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beta cells no longer produce insulin
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DM type 2 problem
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Ability of beta cells to produce insulin decreased; decreased sensitivity of insulin receptors in target tissues
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Type 1 DM formerly called
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insulin dependent diabetes
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type 2 dm formerly called
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non-insulin dependent diabetes
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Type 1 dm age of onset
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<20
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Type 2 dm age of onset
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>35
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Type 1 dm physical findings
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thin, ill appearance
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type 2 dm physical findings
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usually obese
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type 1 dm early symptoms
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polyuria
polydypsia (excessive drink) polyphagia weight loss blurred vision fatigue dehydration sores that heal slowly |
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type 2 dm early symptoms
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polyuria
polydypsia polyphagia weight loss blurred vision fatigue dehydration sores that heal slowly |
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type 1 dm late symptoms
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decreased level of consciousness
paresthesias visual impairment urinary/gi problems microvascular changes metabolic acidosis |
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type 2 dm late symptoms
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similary to type 1, but more macrovascular than microvascular problems
metabolic acidosis |
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drugs used to treat type 1 dm
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insulin
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drugs used to treat type 2 dm
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oral antidiabetic agents
insulin if necessary |
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specific kinds of insulin
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rapid-acting
short-acting intermediate acting extended long-acting |
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Major categories of oral antidiabetic agents:
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oral hypoglycemic agents(secretagogues)
biguanides (insulin resistance reducers) insulin sensitizers (thiazolidinediones) glucose absorption inhibitors (alpha-glucosidase inhibitors) |
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oral hypoglycemic agents (secretagogues) MOA:
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stimulate beta cells to produce insulin
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biguanides (insulin resistance reducers) MOA:
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decrease liver glucose production and intestinal glucose absorption
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insulin sensitizers (thiazolidiniones) MOA:
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activate insulin receptors, allow glucose to be utilized
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glucose absorption inhibitors (alpha-glucosidase inhibitors) MOA:
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interfere with dietary carbohydrate digestion in sm. intestine so that glucose absorption is delayed
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A major adverse effect of the oral hypoglycemic agents is
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hypoglycemia
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complications of dm include abnormally low levels of blood glucose called ______ and abnormally high levels of blood glucose called ________.
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hypoglycemia
hyperglycemia |
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Hypoglycemia has a danger of ____ _______
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insulin shock
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hyperglycemia has a danger of ________ ________
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diabetic coma
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causes of hypoglycemia
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OD of insulin
omission of meals heavy exercise errors in insulin injection technique weight loss disease that can cause hypoglycemia drugs that can alter insulin action |
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causes of hyperglycemia
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infection
trauma MI or other severe stress noncompliance with treatment regimen |
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symptoms of hypoglycemia
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weakness
diaphoresis (sweating) shakiness tremors nervousness headache hunger irritability progressive confusion convulsions coma |
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symptoms of hyperglycemia
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drowsiness
red,dry skin fruity breath odor unusual thirst increased urination rapid, deep breathing |
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treatment for hypoglycemia
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administer glucose
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treatment for hyperglycemia
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administer insulin
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________ and ________ are the cornerstone of therapy for both type 1 and type 2 dm
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exercise and diet
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The _________ _______ test is currently the best measure of glycemic control in diabetics and indicates the ________ ________ _______ level for the previous ___ to ___ days.
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hemoglobinA1c
average plasma glucose level 60 to 90 |
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The ________ __________ is morning rebound hyperglycemia which occurs in response to nocturnal hypoglycemia by administration of excessive _______.
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somogyi phenomenon
insulin |
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________ is a condition of atrophy of subcutaneous tissue and is caused by incorrect insulin administration; that is, sites were not _______ systematically
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Lipodystrophy
rotated |
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Insulin must be administered _______ because gastric acid would destroy it if swallowed.
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parenterally
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Insulin can be given ________ or ______. the most common route is ____.
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subcutaneously
intravenously sub-cu |
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insulin is given in increments of _____. Patients taking insulin should wear a _______ ________ _______.
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units
medical alert bracelelet |
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If a patients must take insulin before meals, _______ insulin is routinely administered by a ________ ________.
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regular
sliding scale |
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If a patients must take insulin before meals, _______ _____levels are checked and a certain amount of insulin is adminstered approx. _____minutes before a meal according to physicians orders
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blood glucose
30 |
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The ___ __________ _________ _________ inhibit the action of histamine at the histamine (H2) receptor sites and decrease ________ ______.
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H2 histamine receptor antagonists
gastric acid |
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H2 histamine receptor antagonists used to treat:
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treat ulcers
prevent stress ulcers hyperacidity GI bleeding prevent allergic responses GERD |
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Patient teaching for H2 histamine receptor antagonists should include:
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limit caffeine intake
take before meals (ac) and at bedtime (hs) DO NOT take with antacids |
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THe ________ ________ _______ block the enzyme that secretes the hydrogen ion or proton into the ________ cells of the stomach thereby blocking the production and secretion of hydrochloride acid.
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proton pump inhibitors
parietal |
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Proton pump inhibitors block the ____________ enzyme system responsible for acid production (hydrogen-potassium pump)
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H+K+ATPase
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Proton pump inhibitors are used to treat:
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-severe erosive esophagitis not responsive to H2 histamine receptor antagonists
-short-term treatment of active peptic ulcer disease -gastric hypersecretion disorders |
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Patient teaching for Proton pump inhibitors should include
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antacids CAN BE taken with these agents
report any changes in urinary elimination or diarrhea |
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________ _____________ _______ protect the gastric mucosal lining from hyperacidity which can result in _______-___________.
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Gastric mucosa protectants
auto-digestion |
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chemically unlike any other drug used for anti-ulcer therapy _____ reacts with gastric acid to form a viscous, adhesive paste-like substance which forms a barrier at the ulcer site. It must be taken on an _______ _________ for best results
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sucralfate (Carafate)
empty stomach |
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A synthetic prostaglandin, _________ has both antisecretory and gastric muscosal protective properties for patients who do not resond to treatment with ___ __________ ________ _____.
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misopostol (Cytotech)
H2 histamine receptor antagonists |
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misoprostol (Cytotech) must be taken with ______ to prevent gastric ulcers produced by ________ therapy.
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food
NSAID |
