Ch 47, Antidiabetics Flashcards
Diabetes mellitus is characterized by the three Ps:
polyuria, polydipsia, and polyphagia.
The normal range for fasting blood glucose ___-___
is 70–99 mg/dL.
When the blood glucose level is greater than _____, glycosuria can occur.
180 mg/dL
Increased blood glucose acts as an ______ ______, causing ____. (r/t renal)
osmotic diuretic
polyuria
When blood glucose remains elevated (>____ mg/dL), diabetes mellitus occurs.
> 200 mg/dL
The HbA1c level reflects the average glucose level for up to ______.
3 months
In monitoring treatment, the goal is to keep the diabetic’s HbA1c below _____%.
7%
For diagnostic purposes, an HbA1c level of __ or less indicates that the patient does not have diabetes, ____ to ___ indicates prediabetes, and ___ or greater indicates a diagnosis of diabetes mellitus.
5%
5.7% to 6.4%
6.5%
_______ injections of insulin are absorbed faster than other body sites and found to be more consistent.
Abdominal
Insulin injection sites should be rotated to prevent _____, which can interfere with insulin absorption.
lipodystrophy
_____ and _____ increase the need for insulin. Insulin doses should not be withheld during ________, including ____ and _____
Illness and stress
illness, including infections and stress.
_____-acting and ____-acting insulins are in a clear solution.
Rapid
short
_______-acting insulins are cloudy and may contain ________
Intermediate
protamine
_____ is a protein that prolongs the action of insulin, or ____, which also slows the onset of action and prolongs the duration of activity.
Protamine
zinc
Rapid-acting insulins include ____, _____, ______, and _______.
insulin lispro, human insulin aspart, insulin glulisine, and human oral inhalation insulin.
_____ insulins must be administered within 10–15 min before mealtime.
Rapid-acting
Short-acting insulin has an onset of action of ___ min. The peak action occurs in__ - ___ , and the duration of action is ____- ____ .
30 min
2.5–5 h
4–12 h
Regular insulin is _____-acting insulin that can be administered ________ or _______. Regular insulin is generally given ____ - _____min before meals.
short acting
intravenously or subcutaneously
30-60 min
neutral protamine Hagedorn (NPH) is _____ acting insulin
Intermediate-acting insulin
The onset of intermediate-acting insulin is __-__, peak action occurs in __-__ , and the duration of action is __–__ .
1–2 h
4–12 h
14–24 h
Insulin glargine is ____-acting insulin
long-acting
Insulin glargine insulin has an onset of __–___ . It is evenly distributed over a ___ duration of action; thus, it is administered __ a day, usually at _____
1–1.5 h
24
once a day
bedtime.
____ has a low incidence of nocturnal hypoglycemia is not as common as with other insulins.
Insulin glargine
Insulin detemir is ______ insulin that peaks in __-__ and lasts for __-___.
long-acting
6–8 h
12–24 h
Insulin degludec, is _____ insulin, has an onset of __, peaks at ___, and lasts for ____.
long-acting
1 h
12 h
42 h
Unopened insulin vials are ________ until needed. Once an insulin vial has been opened, it may be kept at room temperature for ___ month or in the refrigerator for __ months.
refrigerated
1 month
3 months
Drugs such as ______, _______, _______, and ______ increase the blood sugar.
thiazide diuretics, glucocorticoids, thyroid agents, and estrogen
Drugs that decrease insulin needs are _____, ________, _______ products and ______________.
tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), aspirin products, and oral anticoagulants.
hypoglycemic symptoms
The person may exhibit nervousness, trembling, and lack of coordination; have cold and clammy skin; and complain of a headache. Some patients become combative and incoherent.
Oral antidiabetic drugs should be used by those with type __ diabetes
2
____used to treat insulin-induced hypoglycemia when other methods of providing glucose are not available.
Glucagon
Metformin action (3)
- biguanide compound that acts by decreasing hepatic production of glucose from stored glycogen
- decreases the absorption of glucose from the small intestine,
- evidence that it increases insulin receptor sensitivity as well as peripheral glucose uptake at the cellular level.
_______ does not produce hypoglycemia or hyperglycemia.
Metformin
Metformin contraindication/ side effect
renal impairment
se: GI disturbances.
Metformin therapy should be withheld for __ before and after administration of IV contrast because _____ or _______ may develop.
48 h
lactic acidosis
acute renal failure
