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Nursing School > Anti-diabetic, gastrointestinal, deficiency anemia, hematopoietic agents > Flashcards

Anti-diabetic, gastrointestinal, deficiency anemia, hematopoietic agents Flashcards

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1
Q

Manifestations of Diabetes Mellitus

A

poydipsia, polyphagia, polyuria (more common in type 1) type 2 may be more asymptomatic initially

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2
Q

Complications of diabetes mellitus

A

vascular injuries found in the eye, kidney, brain, heart, extremities, and neuropathy

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3
Q

Diagnostics for diabetes mellitus

A

HA1C q3 months for pt with diabetes, FPG (fasting plasma glucose)

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4
Q

Rapid acting insulin

A

Novolog, Humalog, Apidra

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5
Q

Short acting (regular) insulin

A

Novolin R, Humulin R

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6
Q

Intermediate acting (NPH)

A

Novolin N, Humulin N

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7
Q

Long acting insulin

A

Lantus, Levemir

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8
Q

Metformin (Glucophage) class and indications

A

Biguanide class oral antidiabetic (first line)
lowers glucose but does not stimulate insulin release indicated for Type 2 and gestational DM

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9
Q

Adverse effects of Metformin (Glucophage)

A

N/D, decreased appetite, toxicity related lactic acidosis, decreased B12 and folic acid absorption

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10
Q

Nursing considerations Metformin (Glucophage)

A

LA signs, monitor renal, stop for contrast CT and for admission, B12 and folic acid supplement, potential for weight loss

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11
Q

Metformin (Glucophage) MOA

A

Sensitizes insulin receptors in target tissues, inhibits gastric glucose reabsorption, inhibits hepatic gluconeogenesis

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12
Q

Glipizide (Glucotrol) class and indication

A

Sulfonylurea class, Type 2 DM

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13
Q

Glipizide (Glucotrol) MOA

A

stimulates pancreatic insulin release by binding with and blocking ATP-sensitive potassium channels in the cell membrane to cause depolarization

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14
Q

Adverse effects Glipizide (Glucotrol)

A

hypoglycemia (more likely with kidney and or liver dysfunction), rare SJS/TENS and CV toxicity

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15
Q

Nursing considerations Glipizide (Glucotrol)

A

monitor for hypoglycemia, contraindicated for pregnant or breastfeeding, avoid alcohol, beta blockers can diminish benefits of sulfonylurea (glipizide)

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16
Q

Pioglitazone (Actos) class and indication

A

Thiazolidinediones class, Type 2 DM

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17
Q

MOA Pioglitazone (Actos)

A

activates PPAR gamma to turn on insulin-responsive genes that are responsible for carp and lipid metabolism

18
Q

Adverse effects Pioglitazone (Actos)

A

HF 2/2 fluid retention, ovulation in premenopausal women, increased risk of fractures in women, bladder cancer

19
Q

Nursing considerations Pioglitazone (Actos)

A

monitor and educate ab HF s/s, assess GU history, interactions with CYP2C* inhibitors (atorvastatin, ketoconazole, rifampin, cimetidine)

20
Q

Acarbose (Precose) class and Indications

A

Alpha-glucosidase inhibitor, Type 2 DM

21
Q

Acarbose (Precose) MOA

A

delays absorption of dietary carbohydrates to reduce postprandial hyperglycemia by inhibiting glucosidase that is needed for complex carb catabolism

22
Q

Acarbose (Precose) adverse effects

A

GI, liver dysfunction, anemia b/c of decreased absorption of Fe (iron)

23
Q

Acarbose (Precose) nursing considerations

A

hypoglycemia if used with insulin or sulfonylurea, monitor LFT and s/s liver dysfunction

24
Q

Canagliflozin (Invokana) class and indication

A

Sodium-glucose Co-transporter 2 (SGLT-2) inhibitor, Type 2 DM

25
Q

Canagliflozin (Invokana) MOA

A

Inhibits SGLT-2 to block receptor reabsorption of filtered glucose, leading to glucosuria

26
Q

Sitagliptin (Januvia) class and indications

A

Dipeptidyl peptidase-4 (DPP-4) inhibitor, Type 2 DM (usually adjunct with metformin)

27
Q

Sitagliptin (Januvia) MOA

A

enhances actions of incretin hormones to stimulate glucose-dependent release of insulin and suppress postprandial release of glucagon by inhibiting DPP-4

28
Q

Semaglutide (Ozempic/Wegovy) class and indication

A

Glucagon-like peptide-1 (GLP-1) class SQ injectiable, Type 2 DM (can be used w/ozempic with CV benefits or chronic weight management as Wegovy)

29
Q

MOA Semaglutide (Ozempic/Wegovy)

A

activates GLP-1 receptors to cause same effects as endogenous incretins (slow gastric emptying, stimulate release of insulin, inhibit postprandial glucagon release, suppress appetite)

30
Q

Adverse effects Semaglutide (Ozempic/Wegovy)

A

N/V/D, increased risk of pancreatitis and renal impairment/AKI, hypersensitivity reaction, possible MTC (medullary thyroid carcinoma)

31
Q

Tirzepatide (Monjaro) class and indication

A

Glucose-dependent insulinotropic (GIP) & glucagon-like peptide-1 (GLP-1) class SQ injection, Type 2 DM

32
Q

Tirzepatide (Monjaro) MOA

A

GLP-1 agonist effects, acts as agonist at GIP receptors to produce similar effects

33
Q

Tirzepatide (Monjaro) adverse effects

A

GI (N/V/D), constipation, abdominal pain, increase risk pancreatitis, renal impairment/AKI, hypersensitivity, possible MTC (medullary thyroid carcinoma)

34
Q

Glargine (Lantus) indication, class

A

Long acting once or twice daily insulin
Stimulates glucose, amino acids, nucleotides, and K
Basal glycemic control in Type 1 & 2 DM
SQ NEVER IV

35
Q

Adverse effects Glargine (Lantus)

A

hypoglycemia, hypokalemia, lipohypertrophy

36
Q

Nursing considerations Glargine (Lantus)

A

baseline labs and monitor glucose, rotate injection site, Clear medication (throw out and don’t use if cloudy), **usually admin HS but can be twice

37
Q

Glulisine (Apidra) indication and MOA

A

Rapid acting insulin that stimulates uptake of glucose, amino acids, nucleotides, and K+
Postprandial glycemic control in Type 1 & 2 DM

38
Q

Glulisine (Apidra) adverse effects

A

hypoglycemia, hypokalemia, lipohypertrophy

39
Q

Nursing considerations Glulisine (Apidra)

A

baseline labs and monitor glucose, rotate injections, clear medication (cloudy throw out), **administered AC (before meals) and PC (after meals)

40
Q

Regular (Humulin R/Novolin R) indication and action

A

Short acting insulin stimulates uptake of glucose, amino acids, nucleotides, and K+
Postprandial glycemic control via SQ injection or basal glycemic control via SQ infusion in type 1 & 2 DM

41
Q

Regular (Humulin R/Novolin R) adverse effects

A

hypoglycemia, hypokalemia, lipohypertrophy

42
Q

Regular (Humulin R/Novolin R) nursing considerations

A

baseline labs and monitor glucose, rotate injection site, clear medication (throw out if cloudy), **administer 20-30 minutes AC (before meals)

Nursing School (9 decks)

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