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Pharmacology > Ch 38 Agents to Control Blood Glucose Levels > Flashcards

Ch 38 Agents to Control Blood Glucose Levels Flashcards

1
Q

what is insulin?

A

hormone produced by beta cells in the Islets of Langerhans; lowers blood sugar

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2
Q

when is insulin released?

A

released into circulation when levels of glucose around the cells rise; released after meals causing blood glucose levels to fall

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3
Q

what does insulin stimulate?

A

stimulates glycogen synthesis, conversion of lipids into fat stored as adipose tissue, and synthesis of proteins from amino acids

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4
Q

what is glucagon and when is it released?

A

release from alpha cells into islets of langerhans in response to low blood glucose; causes immediate mobilization of glycogen stored in the liver and raises blood glucose levels

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5
Q

what happens when not enough insulin is released in the body?

A

hyperglycemia, glycosuria, polyphagia, polydipsia, lipolysis, ketosis, acidosis, polyuria

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6
Q

what is the level indicating hypoglycemia?

A

< 70

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7
Q

at what level is insulin given in the hospital?

A

> = 150

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8
Q

what is the normal blood glucose level?

A

70-100

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9
Q

what are features of Diabetes Mellitus?

A

complex disturbances in metabolism; affects carbohydrate, protein, and fat metabolism

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10
Q

what are clinical signs of Diabetes Mellitus?

A

hyperglycemia (fasting blood sugar level > 126 mg/dL)
glycosuria (presence of sugar in the urine)

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11
Q

what are disorders associated with Diabetes?

A

atherosclerosis, retinopathy, neuropathic pain, nephropathy

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12
Q

what is type 1 diabetes?

A

insulin dependent DM; usually a rapid onset seen in younger people, connected in many cases to viral destruction of the beta cells of the pancreas

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13
Q

what is type 2 diabetes?

A

non-insulin dependent DM that usually occurs in mature adults and has a slow and progressive onset; normally caused by sedentary lifestyle

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14
Q

what are signs of hyperglycemia?

A

fatigue, lethargy, irritation, glycosuria, polyphagia, polydipsia, itchy skin

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15
Q

what are concerning complications of hyperglycemia?

A

fruity breath, dehydration, slow/deep respirations, loss of orientation, coma

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16
Q

what is the initial response of hypoglycemia?

A

parasympathetic stimulation followed by fight or flight reaction –> breakdown of fat and glycogen to release glucose –> pancreas releases glucagon to increase glucose and somatostatin

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17
Q

what are symptoms of hypoglycemia?

A

nausea, pale cool moist skin, headache, confusion, dizziness, unconsciousness, numbness around lips, diaphoresis

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18
Q

what are symptoms of hyperglycemia?

A

dim vision, thirst, dry flushed warm skin, nausea, abdominal pain

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19
Q

what are symptoms of DKA?

A

acetone breath, ketones in urine, excessive urination

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20
Q

What does insulin treat?

A

type 1 and type 2

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21
Q

when is insulin used in type 2 DM?

A

when the disease is not controlled by diet or other agents

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22
Q

what are adverse reactions of insulin?

A

hypoglycemia, lipodystrophy, sire irritation

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23
Q

what drug masks the signs of hypoglycemia?

A

beta blockers

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24
Q

what should a nurse teach a patient who is taking insulin?

A

rotate injection sites

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25
What are the 3 important properties of insulin?
onset peak duration
26
which insulins cannot be mixed?
long acting and very long acting
27
What type of insulin is rapid?
Humalog (Lispro) and Novolog (Aspart)
28
what type of insulin is short acting?
Regular
29
what type of insulin is intermediate?
NPH
30
what type of insulin is very long acting?
Glargine Lantus
31
what is the onset of Humalog?
5-15 min
32
what is the onset of Novolog?
10-20 min
33
what is the onset of regular?
30 min
34
what is the onset of NPH?
1-3 hours
35
what is the onset of Glargine Lantus?
1 hour
36
what is the peak of Humalog?
30-75 min
37
what is the peak of Novolog?
1-3 hours
38
what is the peak of regular?
2-5 hours
39
what is the peak of NPH?
6-12 hours
40
what is the peak of glargine Lantus?
no peak; evenly for 24 hours
41
what is the duration of Humalog?
2-3 hours
42
what is the duration of Novolog?
2-4 hours
43
what is the duration of Regular?
2-5 hours
44
what is the duration of NPH
16-24 hours
45
what is the duration of glargine Lantus?
24-28 hours
46
when is the patient most at risk for hypoglycemia when taking insulin?
at the peak
47
What type of diabetes is oral anti diabetics used?
type 2
48
what is the medication name for sulfonylureas?
glyburide (Diabeta, Micronase) 2nd gen
49
what is the action of sulfonylureas?
bind to K+ channels on pancreatic cells to increase insulin receptors are stimulate the release of insulin
50
what are the adverse effects of sulfonylureas?
hypoglycemia, metallic taste, GI upset
51
what should the nurse consider when giving sulfonylureas?
increased risk of cardiovascular disease with 1st generation drugs 2nd generation advantage is excreted in urine and bile & longer duration of action
52
What is the medication name for Biguanide?
Metformin (glucophage)
53
what is the action of metformin?
effective in use with a combination of insulin or a sulfonylurea; increases insulin production and lowers glucose production
54
what are adverse reactions of metformin?
hypoglycemia, lactic acidosis, vitamin B12 deficiency, Gi upset
55
what type of DM is metformin used for?
type 2
56
what should the nurse consider when giving metformin?
low carb diet kidney and liver function monitor blood glucose levels
57
what increases the risk of toxicity with metformin?
IV contrast dye
58
What is a glucose elevating agent?
Glucagon (GlucaGen)
59
what is the action of Glucagon?
raise blood glucose levels by decreasing insulin release
60
what does glucagon treat?
hypoglycemia
61
what are adverse reactions of glucagon?
hyperglycemia, hypokalemia, vascular effects (hypotension, headaches), GI upset
62
what should the nurse consider when giving glucagon?
monitor for signs of hypo/hyperglycemia repeat blood glucose level to ensure effectiveness

Pharmacology (11 decks)

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