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Pharmacology > Antidiabetics (52) > Flashcards

Antidiabetics (52) Flashcards

1
Q

Diabetes Mellitus (DM) is the deficiency in ____ metabolism caused by lack of inefficient use of ____ in the body.

A

glucose… insulin

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2
Q

Type 1 Diabetes is the insulin-dependent (IDDM) –> no pancreatic reserve of insulin which requires ____ insulin therapy.

A

daily

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3
Q

Type 1 Diabetes (IDDM)

wide variations in ____ glucose levels which makes them more prone to ____

A

blood… ketosis.

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4
Q

Types 2 Diabetes (NIDDM) is a non-insulin-dependent which allows some residual ____ function

A

pancreatic.

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5
Q

Type 2 NIDDM:

  1. Can be controlled by weight loss and special diet
  2. Diet & oral hypoglycemic agents
  3. Less prone to ____
A

ketosis.

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6
Q

Secondary DM happens usually due to certain drugs that increase blood sugar which causes ____ in pre diabetic persons –> blood sugar usually returns normal after ____ of drug

A

hyperglycemia… discontinue

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7
Q

Gestational DM:
2nd and 3rd trimesters which cause hormone levels to increase (inhibits ____ effectiveness)
After pregnancy it returns to ____.

A

insulin… normal

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8
Q

Insulin is secreted by ____ cells of the islets of ____ of pancreas.

A

Beta… Langerhans…

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9
Q

Normal blood glucose is 60-100 mg/dL
Normal serum (plasma) glucose is 70-100 mg/dL
>180 mg/dL means ____.

A

glycosuria…

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10
Q

HbA1C reflects average ____glucose level up to 3 months and the GOAL is to keep it below ____.

A

glucose… 7%

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11
Q

Insulin Therapy is dosaged in ____. Insulin syringes –> U-100 = 100 units of insulin per milliliter. U-500 will need prescription. Need doses more than 200 units insulin daily.

A

units.

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12
Q

Insulin Therapy: 10 mL vials should be stored in refrigerator and avoid ____ temperatures.

A

extreme

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13
Q

Routes of Adm for Insulin:

  1. SC (SubQ) is the pre-filled insulin pen which is more accurate but more ____, although less painful.
  2. IV (Regular type only) requires insulin ____ –> implantable / portable.
A

expensive… pump

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14
Q

Insulin pump is more effective than ____ injections and gives constant amount of insulin.

A

multiple

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15
Q

Rapid Acting Insulin:

  1. lispro (Humalog)
  2. insulin aspart (NovoLog)

Onset of action is 5-15 minutes.
Peak action:
HumaLog –> ____ minutes
NovoLog –> ____ hours

A

30-90… 1-3

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16
Q

Duration of Rapid Acting Insulin:
HumaLog: 2-5 hours
NovoLog: 3-5 hours
Appearance is clear and administer 5 minutes before meal

A

SEE OTHER SIDE

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17
Q

Short acting (Regular) Insulin:
Humalin R
Novolin R

Onset: 30 minutes
Peak: 2.5 - 5 hours
Duration: 6-8 hours

Appearance is clear and should be administered about 30 minutes before meal (ONLY TYPE OF INSULINE THAT CAN BE GIVEN THROUGH ____)

A

IV

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18
Q 
Intermediate acting Insulin
Insulin NPH (Humulin N & Novolin N)
Onset: 1-2 hours 
Peak: 6-12 hours
Duration: 18-24 hours

Cloudy in appearance and should be administered 1 hour before ____.

A

breakfast

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19
Q

Combination Products:
70% NPH & 30% Reg
50% NPH & 50% Reg
b.i.d before ____

A

meals

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20
Q

Adverse Effects of Insulin:

Hypoglycemia may be d/t omitting / irregular scheduled meals, increased ____, and/or administration ____

A

exercise… errors.

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21
Q

Insulin Hypoglycemic Reaction (S/S):
Sweating, ____, tachycardia, HA, hunger, and weakness which could lead to Coma or Death if blood sugar levels get below ____ mg/dL.

A

confusion… 60

22
Q

Tx for hypoglycemic reaction to insulin:
____ (oral)
____ (parenteral, if unconscious)

A

glucose… glucagon

23
Q

Insulin Lipodystrophy is the atrophy or hypertrophy of ____ fat at injection sites. To prevent, ____ sites and ____ site after injection

A

SC(SubQ)… rotate… message.

24
Q

Insulin resistance will need for ____ doses of insulin

A

high

25
Q

Coverage Orders (Sliding Scale Example):
0-180 mg/dL requires no coverage
181-240 mg/dL requires ____ units SC
241-300 mg/dL requires ____ units SC

A

2…4

26
Q

Administration of Insulin:
Always use insulin ____.
U-100 syringes = 100 units/mL

A

syringe

27
Q

Lo-dose syringes are ____ units and are for smaller doses of insulin.

A

30-50

28
Q

Injection Sites:
Abdomen has fastest absorption and easier for self-inject
Thigh is easier for self-inject

A

SEE OTHER SIDE

29
Q

Make sure to rotate site, otherwise it may cause ____ (Establish rotation pattern and keep track, document site used).

A

hypoglycemia.

30
Q

Measure 2 types of insulin in same syringe:

  1. Gently roll long acting insulin vial
  2. Clean both stoppers on vials
  3. Aspirate into longer acting insulin
  4. Aspirate and WITHDRAW from regular insulin
  5. WITHDRAW intermediate insulin
  6. After mixing Regular & Intermediate insulin
  7. Administer within ____ minutes.
  8. Intermediate insulin will alter functioning of regular insulin.
A

30

31
Q

When mixing two insulins –> ____ to ____.

A

Clear… cloudy

32
Q

Insulin Reactions (Hypoglycemia):
IF ABLE to swallow, give rapidly absorbed ____ such as ____, sugar containing drink, hard ____.
IF UNABLE to swallow, give a ____ injection.

A

sugar… OJ… candy… glucagon

33
Q

Glucagon (SQ, IM, IV) tx. insulin-induced ____

A

hypoglycemia

34
Q

Patient should recover 15 minutes within Glucagon tx. IF NO response, contact physician (EMERGENCY)

A

SEE OTHER SIDE

35
Q

DO NOT give Glucagon if a patient is ____

A

fasting.

36
Q

Teach person self-care skills with insulin administration such as blood glucose monitoring, foot care, diet, exercise, medic-alert ID, & S/S of hype and hyperglycemia.

A

SEE OTHER SIDE

37
Q

Oral anti diabetic drugs stimulate pancreatic beta cells to secrete ____ and patient needs to have some pancreatic function.

A

insulin

38
Q

Type 2 diabetes (NIDDM) does not respond to diet alone. Best response is if dx after age ____, not ____, and will need ____ units of insulin daily.

A

40… overweight… <40

39
Q

Sulfonylureas (1st and 2nd Generations) stimulate pancreatic beta cells to secrete ____.

A

insulin.

40
Q

1st Generation Sulfonylureas Ex//
tolbutamide (Orinase) - short acting
tolazamide (Tolinase) - intermediate acting
chlorpropamide (Diabenese) - long acting

A

SEE OTHER SIDE YOU FOOL

41
Q

2nd Generation Sulfonylureas are more ____, great hypoglycemia ____, longer ____, and fewer ____.

A

potent… potency… duration… SE

42
Q

2nd Generation Sulfonylureas Ex//
glimepiride (Amaryl)
glipizide (Glucotrol)
glyburide (DiaBeta, Micronase)

Administer one or more times a day.

A

SEE OTHER SIDE

43
Q 
Adverse effects of 2nd Gen Sulfonylureas:
Hypoglycemia
\_\_\_\_ / Jaundice
GI distress
\_\_\_\_ disorders.
A

Hepatotoxicity… hematological

44
Q

Hypersensitivity Rxns to 2nd Gen Sulfonylureas:

____ will cause flushing, nausea, ____.

A

Alcohol… palpitations

45
Q

Biguanides decrease ____ production of glucose from stored glycogen, which reduces the increase in serum glucose after a meal.

A

hepatic

46
Q

Biguanide example:
metformin (Glucophage) increases insulin receptor sensitivity. Administer 500 mg 1-3 times/day with ____ and ____ dose gradually.

A

meals… increase.

47
Q

metformin S/S

  1. does NOT produce hypo or hyperglycemia
  2. GI effects
  3. Bitter ____ taste
A

metallic.

48
Q

Avoid alcohol when on metformin and observe for lactic ____

A

acidosis

49
Q

Oral anti diabetics should be administered with food to decrease ____ upset. Also, monitor ____ levels.
Blood glucose –> 60-100 mg/dL
Serum glucose –> 70-110 mg/dL

A

GI… blood sugar.

50
Q

when patient on anti diabetics, teach to recognize s/s (hypo & hyperglycemia). May need insulin during stress, ____, and serious ____. ALSO, tell patient to use MedicAlert card, tag, bracelet, and a ____.

A

surgery… infection… glucometer

Pharmacology (8 decks)

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