Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

pharm 140 > blood glucose levels 49 > Flashcards

blood glucose levels 49 Flashcards

1
Q

what percentage of the population has DM?

A

7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which is more common, DM 1 or DM2?

A

DM2 (90-95%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

metabolic changes when insufficient insulin is released

A 
hyperglycemia
glycosuria
polydipsia
lipolysis
ketosis
acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hyperglycemia results from what 3 main abnormalities?

A
  1. excessive glucose production in liver
  2. absent or impaired glucose production and secretion by the pancreas
  3. peripheral insulin resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

type 1 diabetes

A

autoimmune disorder characterized by the destruction of insulin-secreting beta cells in the pancreas, leading to absolute insulin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

type 2 diabetes

A

result of insulin resistance by the tissues and usually a decrease in insulin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

gestational diabetes (GDM)

A

occurs when a woman’s pancreatic function is not sufficient to overcome the insulin resistance created by the anti-insulin hormones secreted by the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

insulin functions

A
  • facilitates passage of glucose into cells for energy
  • suppresses excess production of sugar in the liver and muscles
  • inhibits breakdown of fat for energy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

exogenous insulin

A

synthetic insulin

aspart, lispro, glulisine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

insulin interactions

A 
alcohol
beta blockers
dobutamine
niacin
MAOIs
thiazide diuretics
tetracycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

insulin contraindications

A

hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

insulin adverse effects

A

hypoglycemia

lipoatrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

insulin nursing diagnoses

A
  1. deficient knowledge r/t insulin pharmacotherapeutics
  2. risk for non-adherence to self care r/t complexity and chronic nature of insulin regimen
  3. risk for hypoglycemia r/t incorrect insulin administration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

insulin planning/interventions

A

max therapeutic effect: store opened vials at room temperature; administer with an insulin syringe into appropriate subq site

min adverse effects: rotate injection site to prevent lipodystrophy; assess blood glucose prior to administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which subq site provides the most rapid absorption of insulin therapy?

A

abdomen; up to 50% faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

rapid acting insulins

A
  1. aspart (NovoLog)
  2. lispro (Humalog)
  3. glulisine (Apidra)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

rapid acting insulin administration

A 
administer within 15 min of the start of the meal
begins working in 10-20 min
peak 30 min-3 hrs
duration 3-5 hrs
can be used in insulin pumps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

short-acting insulin

A

regular (R) or novolin: acts in 30-60 min, lasts 5-8 hrs

velosulin (used in insulin pump): acts in 30-60 min, lasts 2-3 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

intermediate insulin

A

NPH (N): acts in 1-2 hrs, lasts 18-24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

long-acting insulin

A 
insulin glargine (Basaglar, Lantus, Toujeo) - 20-24 hrs
insulin detemir (Levemir) - up to 24 hrs
insulin degludec (Tresiba) - lasts up to 42 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pre-mixed insulin

A

humulin [70/30, 50/50]
humolog mix [75/25]
novolin [70/30]
novolog [70/30]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

insulin pt education

A 
self glucose testing
carry emergency carbs
never inject cold insulin
do not massage injection site
draw up regular (R) first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

oral hypoglycemic drugs

A 
sulfonylureas (gen1 and gen2)
biguanide
alpha glucosidase inhibitors
meglitinides
thiazolidnediones
24
Q

sulfonylureas

A 
prototype glubiride (DiaBeta)
adjunctive treatment to lower blood glucose levels in DM2
25
Q

glyburide pharmacokinetics

A

given PO
metabolized in liver
excreted thru urine/feces
protein bound

26
Q

glyburide action

A

hypoglycemic action of glyburide results from the stimulation of pancreatic beta cells

27
Q

glyburide contraindications

A

hypersensitivity

28
Q

glyburide adverse effects

A 
hypoglycemia
anorexia
n/v
heartburn
metallic taste
29
Q

glyburide considerations

A

pregnancy category B

pt willingness to follow diet

30
Q

glyburide nursing diagnoses

A

ineffective health maintenance r/t drug induced n/v, abdominal pain and disulfiram reaction 2/2 alcohol ingestion

imbalanced nutrition (more than body requirements) r/t weight gain 2/2 glyburide/sulfonylurea therapy

ineffective protection r/t leukopenia 2/2 bone marrow depression associated with glyburide use

31
Q

glyburide planning/interventions

A

max therapeutic effect: administer before breakfast or first meal of the day

min adverse effect: monitor blood glucose levels to detect hypoglycemia; monitor pts with renal/heptaic impairment for s/s adverse effects

32
Q

nonsulfonylureas

A

three classes:

  1. biguanides
  2. thiazolidinediones
  3. alpha-glucosidase inhibitors

prototype for all nonsulfonylureas is metformin

33
Q

metformin action

A

decreases hepatic glucose production
decreases intestinal absorption of glucose
improves insulin sensitivity by increasing peripheral glucose uptake

it is ADJUNCT to therapy to lower blood glucose in DM2 pts

34
Q

metformin pharmacokinetics

A

given PO
metabolized in liver
excreted in urine

35
Q

metformin contraindications

A

hepatic disease

36
Q

metformin adverse effects

A 
anorexia
GI upset (n/v/d and flatulence)
weight loss
dyspepsia
metallic taste
37
Q

metformin interactions

A

may interact with contrast used in radiographic procedures

alcohol

38
Q

metformin + pregnancy

A

pregnancy category B

39
Q

metformin diagnoses

A

risk for imbalanced nutrition (less than body requirements) r/t anorexia 2/2 adverse GI effects from metformin

40
Q

metformin interventions

A

max therapeutic effect: administer 2x daily with morning and evening meal; adherence to diet/exercise help to control DM2

min adverse effect: take drug at mealtime and increase dose gradually to minimize these effects

41
Q

glucagon

A

glucose-elevating agent (opposite effect of insulin)
hyperglycemic polypeptide hormone produced by alpha cells in pancreatic islets of Langerhans
first line of defense against hypoglycemia
secreted in response to decreased serum blood sugar

42
Q

glucagon pharmacokinetics

A

half life of 3-10 min

43
Q

glucagon action

A

increases blood glucose levels by stimulating glycogenolysis in the peripheral tissues

44
Q

glucagon contraindications

A

hypersensitivity

45
Q

glucagon adverse effects

A

hypotension
respiratory distress
n/v

46
Q

glucagon interactions

A

oral anticoagulant

47
Q

glucagon + pregnancy

A

pregnancy category B

48
Q

glucagon diagnoses

A

risk for injury r/t hypotension from adverse effects of glucagon

49
Q

glucagon interventions

A

max therapeutic effect: use reconstituted glucagon immediately; typical dose is 0.5-1 mg

min adverse effect: administer supplemental carbohydrates as soon as possible

50
Q

rapid acting insulin indications

A

covers insulin needs for meals eaten at the same time as the injection; often used in combination with longer acting insulin

51
Q

short acting insulin indications

A

covers insulin needs for meals eaten within 30-60 min of administration

52
Q

intermediate-acting insulin indications

A

covers insulin needs for about half a day or overnight; often combined with rapid or short acting insulins

53
Q

long-acting insulin indications

A

covers insulin needs for about one full day; often combined with rapid or short acting insulins

54
Q

pre-mixed insulin indications

A

generally taken 2-3x daily before mealtimes

contain specific amts of intermediate and short acting insulin in one bottle or pen

55
Q

drugs that have additive effects when used with insulin

A

sulfonylureas
beta blockers
alcohol

56
Q

drugs that counteract effects of insulin

A

thiazide diuretics

glucocorticoids

pharm 140 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions