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69 Cards in this Set
- Front
- Back
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sulfonylurea |
-most popular -stimulates pancreas to release more insulin -limitations: hypoglycemia -easier on kidney - excreated by BM |
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Biguanide |
-hyperglycemia - oral antidiabetic -reduces glucose production by liver; improves insulin sensitivity -helps reduce high lipid levels |
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an example of biguanide (oral antidiabetic) |
metformin oral antidiabetic |
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alpha-glucoaidese inhibitor example (oral antidiabetic) |
acarbose |
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thiazoildinedione example (oral antidiabetic) |
troglitazone (withdrawn) roeiglitazone ploglitazone |
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alpha-glucosidese inhibitor |
reduces glucose absorption by gut
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thiazolidinedione |
stimulates nuclear PPAR-gamma receptor, reduces insulin reisistance |
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Byetta |
-most common -decrease appetite -with hypoglycemic -a hormone |
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levothyroixine sodium |
-for hypothyroidism cmg, common thyroid hormone replacement drug |
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synthroid |
same as levothyroinine sodium |
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intended responses from thyroid hormone replacement drugs |
body temperature normal, level of activity normal, heart rate, b/p, and resp normal, body weight is maintained, mentally alert, bm pattern is normal |
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side effect of thyroid hormone replacement drugs
adverse effects |
rapid heart rate, high b/p, warm skin, sensation of feeling too warm, sweating, difficulty sleeping, weight loss, increase in the number of bm each day
overwork the heart and lead to angina pain, a heart attack and heart failure |
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before giving thyroid hormone replacement drugs |
-check b/p, heart rate, and thythm -check dose and specific drug name carefully (not interchangeable b/c strength of each drug varies) -best time in morning -given once a day |
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after giving thyroid hormone replacement drugs |
-check b/p, and heart rate -affects blood clotting especially warfarin -check once each shift for sign of increased bleeding (gums, IV sites, in urine, stool or vomitus) |
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warfarin (other name) |
coumadin |
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teach pt about thyroid hormone replacement drugs
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-dose start out low
-increased slowly every 2-3 weeks (normal TH level and normal metabolism) -not to increase beyond prescribed -pulse >20 beats higher than normal rate for 1 week or consistently irregular, notify prescriber) -take daily -if sick don't take orally (contact prescriber to get a parenteral dose) -don't stop taking -check with DR before taking OTC -keep follow up appointments |
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tapazole |
(methimazole) thyroid-suppressing drugs -for hyperthyroidism |
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PTU |
(propylthiouracil) thyroid-suppressing drugs -for hyperthyroidism |
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intended responses for thyroid-suppressing drugs |
body temperature is normal, level of activity is normal, heart rate, b/p, and resp are normal, body weight is maintained, bm normal |
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side effects of thyroid-suppressing drugs
adverse effects |
rash, nausea, headache, muscle aches
bone marrow suppression, hepatotoxic, enhance the action of drugs that reduce blood clotting (anticoagulants) |
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before thyroid-suppressing drugs |
LFT |
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after thyroid-suppressing drugs |
LFT, blood clotting once a shift any signs of increased bleeding, yellowing of skin, WBC reduction (increase risk for infection) |
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teach thyroid-suppressing drugs |
-on warfarin--keep all follow-up appointments -avoid crowds and ppl who are ill -check color of the roof of the mouth and whites of eyes (Jaundice) |
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rapid-acting insulin |
novolog, apidra, humalog |
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short-acting insulin |
humulin R, novolin R |
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intermediate-acting insulin |
humulin N novolin N levemir humulin 70/30 novalin 70/30 humulin 50/50 novolog mix 70/30 humalog mix 75/25 |
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long-acting insulin |
lantus |
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glyburide |
oral antidiabetic drug second-generation sulfonylureas |
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metformin |
oral antidiabetic drug biguanides |
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actos |
oral antidiabetic drugs thiazolidinediones |
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signs and symptoms of ketoacidosis |
abdominal pain, blood glucose level >300mg/dL, blood pH less than 7.35, dehydration, "fruity" odor of reath, intense thirst, ketone bodies in blood even after dilution, Kussmaul's respirations (deep and rapid), lethargy to coma, nausea, urine glucose positive, urine ketone bodies positive, warm, dry skin |
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types of drugs for diabetes three major groups of drugs: |
insulin, oral antidiabetic drugs, drugs that increase the amounts of other hormones (incretins and amylin) with insulins |
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type 2 diabetes drugs are used win combination with..... |
diet and exercise |
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insulin therapy goal |
maintain blood glucose normal range, avoid ketoacidosis, prevent or delay the blood vessel changes that lead to organ damage |
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when is insulin therapy used |
type 1 |
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how must insulin be taken and why? |
injections SQ, because insulin is a small protein and is destroyed by stomach acids and intestinal enzymes |
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how is insulin made for injection |
use to be extracted from the pancreases of pigs and cows synthetic and is identical to insulin secreted by humans high alert
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insulins vary by.... |
how fast they work how long the effect last synthetic or come from animal sources |
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NovoLog (rapid-acting, short-acting, intermediate-acting insulin, or long-acting insulin) |
rapid |
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novolog mix 70/30 (rapid-acting, short-acting, intermediate-acting insulin, or long-acting insulin) |
intermediate-acting insulin |
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humulin R (rapid-acting, short-acting, intermediate-acting insulin, or long-acting insulin) |
short acting |
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apidra (rapid-acting, short-acting, intermediate-acting insulin, or long-acting insulin) |
rapid-acting |
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insulin ending in -log is..... |
rapid acting....plus apidra |
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insulin ending in -lin R is..... |
short-acting |
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insulin ending in -lin N and mixes is..... |
intermediate-acting insulin including levemir |
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what insulins can't be mixed with no other insulins? |
levemir and lantus |
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lantus is (rapid-acting, short-acting, intermediate-acting insulin, or long-acting insulin) |
long-acting insulin |
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s/s of hypoglycemia |
anxiety, confusion, loss of consciousness, cool clammy skin, HA, hunger, increased sweating, rapid pounding heart rate, shakiness tremors, weakness |
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side effects of insulin |
from repeated SQ inj. lipohypertrophy, lipatrophy |
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lipohypertrophy |
bump on skin |
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lipatrophy |
indent of skin |
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adverse effects of insulin |
hypoglycemia, insulin shock, allergic reaction (from beef and pork) |
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intended responses of insulin |
glucose normal, no glucose or acetone in urine, lip levels normal |
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four-dose injection regimen |
30 min. before meals |
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before insulin |
1.test blood glucose 2. check insulin vial for color and clarity 3. roll insulin vial 4. syringes 28-30 gauge 1/2-5/16 inch length 5.sites 6. cleanse 7. 90 degree angle (45 small) 8. do not massage, or aspirate |
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after insulin |
s/s of hypoglycemia, ensure pt eats, check glucose level |
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teaching insulin |
does not cur diabetes only part of therapy have spare bottle how to store good for 28 days how to give insulin shot don't skip dose or meal |
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how do oral antidiabetic drugs work? |
trigger pancreatic beta cells to release, act directly on the beta cells, stimulate a brief, burstlike release of insulin
taken right before meals to resemble how the normal pancreas responds |
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oral antidiabetic drugs names |
metformin, glyburide, glipizide, actos, avandia |
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oral antidiabetic drugs response |
lower blood glucose levels in normal range, no glucose in urine |
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side effects of oral antidiabetic drugs |
n/v/d, rash, increased sun sensitivity, blurred vision, fluid retention and anemia, dizziness, back pain, HA, muscle aches, weight gain |
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before giving antidiabetic drugs |
alergies to sulfonamide, meal is available, not taking asa, NSAIDs, warfarin, beta-adrenergic blocker, atb, probenecid |
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after giving antidiabetic drugs |
s/s of hypoglycemia, confusion, cool and clammy skin, tremors, HA, hunger and sweating, simple sugars available, HR and B/P (identify Heart failure) |
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teach patient antidiabetic drugs |
avoid ETOH, before meal, weigh daily |
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oral antidiabetic drugs |
glipizide, glyburide, metformin, actos, avandia |
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common oral combination drugs for type 2 diabetes |
metaglip (glipizide and metformin) glucovance (glyburide and metformin) avandamet (metformin and rosiglitazone) avandaryl (rosiglitazone and glimepiride) |
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common drugs that increase incretins and amylin |
exenatide, liraglutide pramlintide sitagliptin |
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common thyroid hormone replacement drugs |
levothyroxine sodium, synthroid |
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common thyroid-supressing drugs |
tapazole, PTU |
