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NURS212 Exam 1 > AX Presentation (Antidiabetic) > Flashcards

AX Presentation (Antidiabetic) Flashcards

1
Q

what is the mechanism of action for Glipizide(2)?

A
  • stimulates pancreatic islet cells which causes them to create more insulin
  • increases sensitivity to insulin at receptor sites
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2
Q

describe absorption of Glipizide

A

1) rapidly and completely absorbed in the GI tract

2) absorption unaffected by food but causes it to be delayed by 40 minutes

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2
Q

describe metabolism of glipizide

A

may be slowed in patients with renal impairment and renal failure

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3
Q

describe excretion of glipizide

A

may be slowed in patients with renal impairment and renal failure

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4
Q

what are the indications for glipizide?

A

type 2 diabetes mellitus

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5
Q

what are the contraindications associated with glipizide?

A

1) diabetic ketoacidosis
2) sulfonamide sensitivity

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6
Q

what is the drug class/action of glipizide?

A
  • antidiabetic agent; blood glucose lowering agent
  • alimentary tract and metabolism
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7
Q

what is the class/action of NPH/isophane insulin(3)?

A
  • antidiabetic agent (insulin and analogs)
  • alimentary tract and metabolism
  • intermediate-acting and short-acting human insulin and analog combination
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8
Q

what is the mechanism of action for NPH insulin?

A
  • exogenous insulin that functions as a substitute for the endogenous hormone

lowers blood glucose by:
- stimulating glucose uptake in the skeletal muscle and fat
- inhibiting hepatic glucose production
- inhibition of lipolysis and proteolysis
- enhanced protein synthesis

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9
Q

what is the therapeutic effect of NPH insulin?

A

control of hyperglycemia in diabetic patients

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10
Q

what are the indications for NPH insulin(2)?

A

1) diabetes type 1
2) diabetes type 2

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11
Q

what are the contraindications associated with NPH insulin?

A

hypoglycemia

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12
Q

describe the absorption of NPH insulin

A

slower onset and longer duration of action than regular insulin, but not as long as the long-acting insulins

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13
Q

what is the metabolism of NPH insulin?

A

metabolized by the liver, kidneys, spleen, and muscle

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14
Q

describe the distribution of NPH insulin

A

identical to endogenous insulin

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15
Q

what are some side effects of NPH insulin(8)?

A

1) hypoglycemia (can be life-threatening)
2) hypokalemia
3) cutaneous amyloidosis
4) erythema
6) lipodystrophy
7) pruritis
8) swelling

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16
Q

what are some side effects of glipizide(8)?

A

1) photosensitivity
2) rash
3) hypoglycemia
4) hyponatremia
5) constipation
6) cramps
7) thrombocytopenia
8) dizziness

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17
Q

what is the class of glucagon?

A
  • pancreatic hormones
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18
Q

what is the mechanism of action for glucagon?

A

1) activates hepatic glucagon receptors which promotes glycogen breakdown in the liver
* releases glucose and increases blood glucose within minutes

2) relaxes smooth muscles in the gastrointestinal tract (temporarily inhibits peristalsis)

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19
Q

what are the therapeutic effects of glucagon?

A

1) increases blood glucose levels

2) relaxation of GI musculature, facilitating radiographic examination

20
Q

what are the indications for glucagon?

A

1) acute management of hypoglycemia
2) facilitation of radiographic examination
3) betablocker overdose
4) calcium channel blocker overdose

21
Q

describe the absorption of glucagon

A

well absorbed following IM, intranasal, and SUBQ administration.

  • IV maximal glucose concentration: 5-20 minutes
  • IM maximal glucose concentration: 30 minutes
  • SUBQ maximal glucose concentration: 30-45 minutes
  • intranasal maximal glucose concentration: 15 minutes
22
Q

describe the distribution of glucagon

A

extensively distributed to tissues

23
Q

describe the metabolism of glucagon

A

extensively degraded by the liver, kidneys, and plasma

24
Q

what is the half-life values (plasma, intranasal, and IM) for glucagon?

A
  • plasma half-life: 8-18 minutes
  • intranasal half-life: 35 minutes
  • IM injection half-life: 45 minutes
25
Q

what are the side effects/adverse reactions of glucagon(8)?

A

1) epistaxis
2) red/itchy/watery eyes
3) itchy throat
4) nasal congestion
5) rhinorrhea
6) sneezing
7) headache
8) cough

26
Q

what is the class/action of insulin glargine (Lantus)

A
  • alimentary tract and metabolism
  • antidiabetic agents
  • long-acting human insulin and analogs
27
Q

what is the mechanism of action of insulin glargine (Lantus)?

A
  • binds to insulin receptors stimulating glucose uptake in muscles and adipose tissue and inhibits hepatic glucose production
  • regulates fat metabolism
  • regulates protein metabolism
28
Q

describe the absorption of insulin glargine (Lantus)

A

more stable in acidic conditions

29
Q

what is the onset and duration of action with insulin glargine (Lantus)?

A

onset: 1-2 hours
duration of action: 24 hours

30
Q

describe the metabolism of insulin glargine (Lantus)

A

1) metabolized primarily in the liver
2) 2 metabolites are formed M1 and M2

31
Q

describe the excretion of insulin glargine (Lantus)

A
  • primarily in kidneys
  • can be excreted in breast milk
32
Q

what is the half-life of insulin glargine (Lantus)?

A

unknown

33
Q

what are the indications for insulin glargine(Lantus)?

A

1) gestational diabetes
2) neonatal diabetes
3) type 1 diabetes
4) type 2 diabetes when lifestyle mods are insufficient

34
Q

what is the mechanism of action with regular insulin?

A

facilitates the uptake of glucose in muscle and adipose tisssue and inhibits hepatic glucose production

35
Q

what is the routes of regular insulin?

A

can be SUBQ or IV

36
Q

describe the IV onset and duration of action and peak of regular insulin

A

onset: 15 minutes
peak: 15-30 minutes
duration of action: 30-60 minutes

37
Q

describe the onset and peak of regular insulin administered SUBQ

A

onset: begins approx. 30 minutes after injection
peak: 1.5-3.5 hours

38
Q

when is it best to administer regular insulin?

A

30 minutes before meal

39
Q

describe the metabolism of regular insulin

A

metabolized by liver, kidneys, and peripheral tissues

40
Q

how is regular insulin excreted?

A

mostly by the kidneys

41
Q

what are the indication for regular insulin?

A

1) diabetic ketoacidosis
2) type 1 diabetes
3) type 2 diabetes
4) gestational diabetes
5) neonatal diabetes

42
Q

what are the contraindications for regular insulin?

A

hypoglycemia

43
Q

what are acting lengths of regular, NPH, and lantus?

A

regular insulin - short acting
NPH - intermediate
Glargine (Lantus) - long acting

44
Q

describe the frequency of NPH, regular, and glargine

A

regular - with meals
NPH - 2 times daily BID
Lantus - daily QD

45
Q

which insulins can be administered IV?

A

regular insulin only. lantus and NPH need to be administered SUBQ

46
Q

which insulins are high alert medications?

A

regular, lantus, and NPH

47
Q
A

NURS212 Exam 1 (6 decks)

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