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36 Cards in this Set
- Front
- Back
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What are S&S of hypoglycemia?
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Rapid decrease --> sympathetic nervous system enactivated --> tachycardia, palpitations, nervousness, sweating -------------------------------------------slow decrease --> lack of brain fuel --> HA, drowsiness, confusion, fatigue ----------------------------------------------may result in death & coma if not treated
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What are the types of oral hypoglycemics and their mechanisms of action?
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ALPHA GLUCOSIDASE INHIBITORS - delay carb absorption--------- MEGLITINIDES and SULFONYLUREAS- beta stim, inc insulin production --------- BIGUANIDES- dec gluconeogenesis, increase glucose uptake by muscle and fat, decreased absorption of glucose ----------- THIAZOLIDINEDIONES (TZD)- decreased resistance to insulin
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What is the mechanism of tolbutamide?
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class: Sulfonylureas - increase beta stim of pancreas, inc insulin production. ------------other Sulfonylureas - GLIpizide, GLImepride, GLYburide
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What is the mechanism of glipizide?
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class: Sulfonylureas - increase beta stim of pancreas, inc insulin production. ------------other Sulfonylureas - tolbutamide, GLIpizide, GLImepride, GLYburide
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What is the mechanism of Repaglinide?
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class: Metiglinide - beta stimulation. others - nateglinide
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What is the mechanism of acarbose?
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class: alpha glucosidase inhibitor - slows carb absorption in GI
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What is mechanism of Metformin?
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class: Biguanide - dec gluconeogenesis, inc glucose uptake my muscle and fat, slows absorption of glucose
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What is action of Rosiglitazone?
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Class: TZD - decrease resistance to insulin. Other - Pioglitazone
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The onset of action of this hypoglycemic drug is comprable to Humalog.
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Repaglinide (TZD) - must eat within 30 min of taking this
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What oral hypoglycemic drugs should you avoid if pregnant?
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Glipizide, Tolbutamide (sulfonylureas)
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What are the adverse effects of Metformin?
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(Biguanide) - dec absoprtion of Vit B12 and folic acid. Lactic acidoses.
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What are adverse effects of Rosiglitazone?
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(TZD) - raises LDL, fluid retention, hepatotoxic, BLACK BOX WARNING for inc risk of MI
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What are adverse effects of Acarbose?
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(Alapha gluco inhib) - flatulence, abdominal distension, loud bowels
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Patient taking Acarbose has hypoglycemia. What should nurse give to patient?
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NOT SUCROSE. will not be absorbed due to action of meds.
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What drugs will increase hypoglycemic effect when taken with tolbutamide?
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NSAIDS, sulfonamide(antibiotic), ranitidine and cimetidine (Gi drug)
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What is action of Pramlintide?
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analog of amylin --> slows gastric emptying, increases satiety, suppresses post prandial glucagon secretion (overall, lowers glucose levels)
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What is action of Exenatide?
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(incretin mimetic) blocks dipeptidyl peptidase IV (DPP-4), which is an enzyme that deactivates incretins such as GLP-1 and GIP (overall, lowers glucose levels)
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What is Acarbose used for?
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type 2 diabetes when diet and exercise is not enough
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What is Januvia used for?
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(DPP-4 inhbitor) - indicated for type 2 diabetes
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Can patient take Januvia with other diabetic meds?
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cannot be taken with insulin or sulfonylureas due to risk of hypoglycemia
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How is exenatide stored?
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in fridge
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What is used to treat hypothyroidism?
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Levothyroxine
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What is used to treat hyperthyroidism?
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Propylthiouracil & Methimazole, Iodine Preparations, and Propanolol
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What can cause cretinism?
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inadequate iodine intake during pregnancy
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Hyperthyroidism aka
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Grave's disease
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Cardiovascular signs of hyper vs hypo thyroidsm
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hypo - bradycardia, low BP, low HR
hyper - tachycardia, in cardiac output, inc BP |
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What is the usual onset of action for PTU?
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propylthiouracil (hyperthyroidism) - 3-12 weeks for effect
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What is indication for propylthiouracil
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hyperthyroidism
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What should a nurse monitor for when taking PTU?
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sign of agranulocytosis -fever sore throat --------- signs of hypothyoidism, signs of hyperthyroidsm (inadequate dose)
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What is used for short term treatment of hyperthyoidism?
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Iodine preparations (large amount of iodine reduces thyroid hormone) - ie lugol's solution and SSKI ----------------also propanolol - short term symptom relief
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What is primary indication for glucocorticoid treatment?
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inflammation, skin disorders, cerebral edema
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What are adverse effects of glucorticoid administration
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Moon face and trunk fat, hyperglycemia, fluid retention, psychosis*
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Patient decides to stop corticosteriod therapy. Explain what might happen to pt.
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Since administration suppresses normal amounts of endogenous corticosteroiids, sudden drug discontinuation results in adrenal crisis.shock seizure coma may occur.
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How do you avoid ulcerative disease with oral corticosteriods?
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give with food and milk
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how do you avoid suppression of natural occuring steroids
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IV
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What is an oral vs IV glucocorticoid med?
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oral - prednisone --------- IV - solu-medrol (in ICU emergency)
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