Antidiabetics Flashcards
Type 1 diabetes
AKA juvenile
Insulin-dependent DM
Autoimmune disease: attacks the pancreas
Type 2
non-insulin-dependent DM
Secondary type
Due to medications (glucocorticoids, thiazide diuretics, epinephrine)
Gestational diabetes
Hormonal changes
Why is DM bad
High blood sugar damages blood vessels and nerves→vision changes and decreased blood flow
Function of insulin
moves glucose into the cells
Promotes uptake of glucose, amino acids, and fatty acids
Converts glucose to glycogen in liver and muscle for future glucose needs
Normal range blood glucose
70-100
What is a combination insulin type
Composed of short- and intermediate-acting or rapid- and intermediate-acting (minimize how many times patient is being poked)
(Ex. NPH 70/regular 30. NPH 50/regular 50)
Storage of insulin
Keep in refrigerator until opened.
Avoid storing insulin in direct sunlight or at high temperatures.
Once opened it’s good for a month
Once opened and in a fridge it’s good for 3 months
What is sliding scale insulin
Adjusted doses dependent on individual blood glucose
For rapid or short acting
When to monitor blood glucose
before meals and at bedtime
Insulin side effects
Nervousness, tremors
Headache, confusion, lack of coordination
Cold, clammy skin
Insulin adverse reactions
Hypoglycemia, insulin shock
Diabetic ketoacidosis: hyperglycemia
Treatment of adverse reactions
Juice (PO): can swallow
Dextrose (IV): unconscious.
Glucagon (IV or IM): Raises blood sugar. Tells the body to make its own glucose
(Have IV administer glucose
Don’t have IV administer glucagon)
What is the somogyi effect
Rapid decrease in blood glucose during night stimulates hormonal release to increase blood glucose
What is the dawn phenomenon
Hyperglycemia upon awakening
S&S of dawn phenomenon
Headache, night sweats, nightmares
What is lipodystrophy
tissue gets firm and painful
Lipoatrophy
Lipohypertrophy
Glipzide, glimepiride
MOA
Use
Make more insulin
Treat type 2 diabetes
Side effects of glipizide, glimepiride
Hypoglycemia
GI distress, weight gain
Nervousness, tremors, confusion
Metformin
MOA
Reduces glucose production
Decreases glucose absorption from small intestine
Increase insulin receptor sensitivity
Criteria for use of oral antidiabetic drugs
Onset of diabetes mellitus at age 40 years or older
Diagnosis of diabetes for less than 5 years
Normal weight or overweight
Fasting blood glucose 200 mg/dL or less
Less than 40 units of insulin required per day
Normal renal and hepatic function
Nursing interventions
Administer oral antidiabetics with food to minimize gastric upset.
Monitor blood glucose levels and report changes.
Teach patient to recognize symptoms of hypoglycemia and hyperglycemia.
Teach patient necessity of adherence to diet and drug regimen.
Which time frame would be most appropriate for administering sliding-scale lispro insulin?
A. Within 30 minutes of consuming breakfast
B. When the breakfast tray is served and ready to eat
C. Within 1 hour of obtaining blood glucose measurement
D. Within 15 minutes of obtaining blood glucose measurement
B. When the breakfast tray is served and ready to eat
A patient received regular insulin at 7:30 am. At 9:30 am the patient feels slightly hungry and has a dull headache. The nurse should
A. test the patient’s blood glucose level.
B. ensure that the patient has a meal.
C. provide the patient with 4 ounces of orange juice.
D. administer the next dose of insulin.
A. Test the pt’s blood glucose level
Which statement by a patient taking glipizide indicates that more teaching is indicated?
A. “I will use a new needle every time I take the medication.”
B. “I will take the medication once a day in the morning.”
C. “I will eat my breakfast very soon after taking my glipizide.”
D. “This medication stimulates my pancreatic cells to make insulin.”
A. I will use a new needle every time I take the medication
When teaching the patient about the storage of insulin, which statement will the nurse include?
A. Keep the insulin in the freezer.
B. Warm the insulin in the microwave before administration.
C. Do not place insulin in sunlight or a warm environment.
D. Open insulin vials lose their strength after one year.
C. Do not place insulin in sunlight or a warm environment
A patient with type 1 diabetes mellitus is ordered insulin therapy once daily to be administered at bedtime. What is the type of insulin the patient is most likely receiving?
A. Insulin glargine
B. Lente insulin
C. Lispro insulin
D. Regular insulin
A.Insulin glargine
Insulin lispro (humalog)
Type of insulin
Onset
Peak
Duration
Rapid-acting
15-30 min
30-90 min
3-5 hours
Insulin Aspart (novalog)
Type of insulin
Onset
Peak
Duration
Rapid acting
10-20 min
40-50 min
3-5 hours
Regular insulin
Type of insulin
Onset
Peak
Duration
Short-acting
30-60 min
2-3 hr
5-7 hr
NPH
type of insulin
Onset
Peak
Duration
Intermediate-Acting
1-1.5 hr
8-12 hrs
18-24 hrs
Glargine
Type of insulin
Onset
Peak
Duration
Long-acting
1-1.5 hour
DNE
24 hrs
