Pt 713 Pancreatic Hormones

Front 1

What is insulin?

Back 1

Lowers blood glucose levels by facilitating entry of glucose into the peripheral tissues

Front 2

What is glucagon?

Back 2

Increase and maintain blood glucose levels to prevent hypoglycemia (antagonist to insulin)

Front 3

What are 3 effects of insulin on metabolism?

Back 3

1) Facilitates movement of glucose out of the bloodstream and to the liver for storage (as glycogen)
2) Moves glucose into other tissues via facilitated transport
3) Promotes protein and lipid storage in muscle and adipose tissue

Front 4

What type of diffusion does insulin use?

Back 4

Facilitated diffusion

Front 5

What type of receptor does insulin attach to?

Back 5

Surface receptor linked directly to enzymes

Front 6

What is type I diabetes (insulin-dependent diabetes)?

Back 6

Beta cells are unable to make insulin and receptors work fine (autoimmune disease)

Front 7

What is type II diabetes (non-insulin dependent diabetes)?

Back 7

Beta cells can produce insulin but the receptors do not work well (decreased sensitivity)=insulin resistance

Front 8

What are 7 results of poorly controlled diabetes?

Back 8

1) Neuropathies
2) Retinopathy
3) Risk of CVD
4) Renal failure
5) Risk for seizures
6) Risk for venostasis
7) Feet ulcers

Front 9

What are 4 types of insulin?

Back 9

1) Rapid-acting
2) Intermediate-acting
3) Long-acting
4) Combination preparations

Front 10

What is the peak time for rapid-acting insulin?

Back 10

1.5 to 4 hrs

Front 11

What are 2 types of rapid-acting insulin?

Back 11

1) Animal insulin
2) Synthetic insulin

Front 12

What are 2 disadvantages to using animal insulin rather than synthetic?

Back 12

1) Less easily absorbed
2) High risk for immune response

Front 13

What is synthetic insulin?

Back 13

Identical to human insulin (absorbed the same if not faster)

Front 14

What is the peak time for long-acting insulin?

Back 14

15-24hrs

Front 15

What is combination preparations of insulin?

Back 15

Pre-mixed ratio of rapid and intermediate insulin

Front 16

What is an example of rapid-acting insulin?

Back 16

Lispro (Humalog)

Front 17

What is Lispro (Humalog)

Back 17

A rapid-acting insulin treatment

Front 18

What is an example of intermediate-acting insulin?

Back 18

Humulin L or Insulin Zinc

Front 19

What is Humulin L or Insulin Zinc

Back 19

An intermediate-acting insulin treatment

Front 20

What is an example of long-acting insulin?

Back 20

Glargine (Lantus)

Front 21

What is Glargine (Lantus)?

Back 21

A long-acting insulin treatment

Front 22

What affects insulin absorption?

Back 22

Changes in diet

Front 23

What are 4 ways to administer insulin?

Back 23

1) Subcutaneous injection
2) IV
3) Insulin pump
4) Others like bandaid patches

Front 24

What must you remember to do with subcutaneous injections of insulin treatment?

Back 24

Rotate injection sites around the body and know that exercise can change the absorption in the area of injection

Front 25

What are 3 advantages of using an insulin pump?

Back 25

1) Better insulin control
2) Convenient
3) Less side effects

Front 26

What are 2 adverse effects of insulin?

Back 26

1) Immune reactions when using animal insulin treatment
2) Develop hypoglycemia due to too much insulin (dropping glucose levels)

Front 27

What are 5 early symptoms of an adverse effect of insulin?

Back 27

1) Headache
2) Jitters/Fatigue
3) Clammy
4) Hunger, confused, anxiety
5) Presyncopal symptoms (light headed, dizzy, sweating, nausea, tachycardia)

Front 28

What are 3 later symptoms of an adverse effect of insulin?

Back 28

1) Loss of consciousness
2) Convulsions
3) Death

Front 29

What is the treatment for an adverse effect of insulin?

Back 29

Fast source of sugar, i.e. soda, glucose tablets or candy

Front 30

What are 4 other drugs used for DM?

Back 30

1) Sulfonylureas, benzoic acid derivatives
2) Biguanides (e.g. metformin (glucophage))
3) Thiazoidinediones (TZDs)
4) Alpha-glucosidase inhibitors

Front 31

What drugs cause an increase in beta cell insulin production for type II DM?

Back 31

Sulfonylureas, benzoic acid derivatives

Front 32

What drug's main adverse effect is hypoglycemia?

Back 32

Sulfonylureas, benzoic acid derivatives

Front 33

What does Sulfonylureas and Benzoic acid derivatives do?

Back 33

Increase beta cell insulin production

Front 34

What does Biguanides (e.g.metformin (Glucophage)) do? (2)

Back 34

1) Decrease glucose production in liver
2) Increase insulin sensitivity in peripheral tissues

Front 35

What drugs decrease glucose production in the liver and increase insulin sensitivity in the peripheral tissues?

Back 35

Biguanides (e.g.metformin (Glucophage))

Front 36

What is the main adverse effect of Biguanides (e.g.metformin (Glucophage))? (2)

Back 36

1) GI distrurbances
2) Lactic acidosis (rare)

Front 37

What does Thiazoidinediones (TZDs) do? (2)

Back 37

1) Decrease glucose production in the liver
2) Increase insulin sensitivity in the peripheral tissues
(same as metformin)

Front 38

What are the main adverse effects of Thiazoidinediones (TZDs)? (4)

Back 38

1) Headache
2) Dizziness
3) Fatigue
4) Hepatic toxicity (rare)

Front 39

What do alpha-glucosidase inhibitors do? (2)

Back 39

1) Inhibit intestinal breakdown
2) Delay GI glucose absorption

Front 40

What is the main adverse effect of alpha-glucosidase inhibitors?

Back 40

GI disturbances

Front 41

What drug is the most common type II medication prescribed?

Back 41

Biguanides (metformin (Glucophage))

Front 42

What drug is similar to metformin and decreases insulin resistance in type II DM?

Back 42

Thiazoidinediones (TZDs)

Front 43

What are 3 types of drugs used for type I DM?

Back 43

1) Glucagon
2) Glucagon-like peptide 1 (GLP-1)
3) Immunosuppressants

Front 44

What does Glucagon treatment for type I DM do?

Back 44

Raise glucose levels if there is an hypoglycemic event (can have big side effects)

Front 45

What type I DM drug can have big side effects?

Back 45

Glucagon (works rapidly)

Front 46

What type I DM drug would be injected if there was a hypoglycemic event?

Back 46

Glucagon

Front 47

What is Glucagon-like peptide 1 (GLP-1) used for?

Back 47

Type I DM to lower glucose levels

Front 48

What type of drug would be used to lower glucose levels in Type I DM pts?

Back 48

Glucagon-like peptide 1 (GLP-1)

Front 49

What do immunosuppressants do for type I DM pts?

Back 49

Changes the autoimmune response to beta cells

Front 50

What are 3 non-pharm treatments of DM?

Back 50

1) Proper nutrition
2) Exercise/wt loss
3) Beta cell transplants

Front 51

How does exercise influence DM?

Back 51

Increases insulin sensitivity of peripheral tissue which overcomes insulin resistance

Front 52

What is the significance of DM in rehab?

Back 52

1) Peripheral neuropathies produce functional deficits requiring PT
2) Episodes of hypoglycemia
3) Encourage diet/no skipping meals
4) Educate diet and proper exercise
5) Look for hypoglycemic signs
6) Question patient if taking meds regularly