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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
Q

What are the 3 important properties of insulin?

A

onset
peak
duration

26
Q

which insulins cannot be mixed?

A

long acting and very long acting

27
Q

What type of insulin is rapid?

A

Humalog (Lispro) and Novolog (Aspart)

28
Q

what type of insulin is short acting?

A

Regular

29
Q

what type of insulin is intermediate?

A

NPH

30
Q

what type of insulin is very long acting?

A

Glargine Lantus

31
Q

what is the onset of Humalog?

A

5-15 min

32
Q

what is the onset of Novolog?

A

10-20 min

33
Q

what is the onset of regular?

A

30 min

34
Q

what is the onset of NPH?

A

1-3 hours

35
Q

what is the onset of Glargine Lantus?

A

1 hour

36
Q

what is the peak of Humalog?

A

30-75 min

37
Q

what is the peak of Novolog?

A

1-3 hours

38
Q

what is the peak of regular?

A

2-5 hours

39
Q

what is the peak of NPH?

A

6-12 hours

40
Q

what is the peak of glargine Lantus?

A

no peak; evenly for 24 hours

41
Q

what is the duration of Humalog?

A

2-3 hours

42
Q

what is the duration of Novolog?

A

2-4 hours

43
Q

what is the duration of Regular?

A

2-5 hours

44
Q

what is the duration of NPH

A

16-24 hours

45
Q

what is the duration of glargine Lantus?

A

24-28 hours

46
Q

when is the patient most at risk for hypoglycemia when taking insulin?

A

at the peak

47
Q

What type of diabetes is oral anti diabetics used?

A

type 2

48
Q

what is the medication name for sulfonylureas?

A

glyburide (Diabeta, Micronase) 2nd gen

49
Q

what is the action of sulfonylureas?

A

bind to K+ channels on pancreatic cells to increase insulin receptors are stimulate the release of insulin

50
Q

what are the adverse effects of sulfonylureas?

A

hypoglycemia, metallic taste, GI upset

51
Q

what should the nurse consider when giving sulfonylureas?

A

increased risk of cardiovascular disease with 1st generation drugs
2nd generation advantage is excreted in urine and bile & longer duration of action

52
Q

What is the medication name for Biguanide?

A

Metformin (glucophage)

53
Q

what is the action of metformin?

A

effective in use with a combination of insulin or a sulfonylurea; increases insulin production and lowers glucose production

54
Q

what are adverse reactions of metformin?

A

hypoglycemia, lactic acidosis, vitamin B12 deficiency, Gi upset

55
Q

what type of DM is metformin used for?

A

type 2

56
Q

what should the nurse consider when giving metformin?

A

low carb diet
kidney and liver function
monitor blood glucose levels

57
Q

what increases the risk of toxicity with metformin?

A

IV contrast dye

58
Q

What is a glucose elevating agent?

A

Glucagon (GlucaGen)

59
Q

what is the action of Glucagon?

A

raise blood glucose levels by decreasing insulin release

60
Q

what does glucagon treat?

A

hypoglycemia

61
Q

what are adverse reactions of glucagon?

A

hyperglycemia, hypokalemia, vascular effects (hypotension, headaches), GI upset

62
Q

what should the nurse consider when giving glucagon?

A

monitor for signs of hypo/hyperglycemia
repeat blood glucose level to ensure effectiveness

Pharmacology (11 decks)

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