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Pharmacology > Class 4 > Flashcards

Class 4 Flashcards

1
Q

Function of the pancreas:

A
  1. Secretes digestive enzymes

2. Secretes two hormones that control the metabolism of glucose

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2
Q

Pancreatic Hormones

A

Glucagon & Insulin

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3
Q

Glucagon

A

Hormone that retrieves stored glucose (glycogen) from the liver and coverts it back to glucose (glycogenolysis)

  • Made by alpha cells of the islet of Langerhans in the pancreas
  • Glucagon = alpha cells
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4
Q

Insulin

A

Hormone that assists glucose to enter the cell for use as energy

  • Takes excess glucose from the blood and stores it in the livers.
  • Made by the beta cells of the islets of Langerhans
  • Insulin = beta cells
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5
Q

Glucagon & Insulin

A

Both hormones (glucagon and insulin) are needed for normal glucose metabolism

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6
Q

Hyperglycemia is due to…

A

Due to deficiency of insulin OR resistance to insulin…OR both

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7
Q

Type I Diabetes Mellitus

A

Formally known as Insulin Dependent Diabetes- IDDM)

*10% of all diabetics

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8
Q

Causes of Type I Diabetes Mellitus

A

Lack of insulin production or production of defective insulin

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9
Q

Relationship between Type I Diabetes Mellitus and Insulin

A

THIS PERSON MUST HAVE INSULIN INJECTIONS TO LIVE!

  • Cannot store excess glucose ➢ Glucose lost in urine ➢ Damages the kidneys
  • Excessive glucose is also destruction of the retina (blindness) and sensory nerves (neuropathy in limbs)
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10
Q

Onset of Type I Diabetes Mellitus

A

Sudden symptoms in childhood or early adolescence

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11
Q

Symptoms at onset for Type I and Type II Diabetes Mellitus

A

Polydyspia (↑ thirst)

Polyphagia (↑ hunger)

Polyuria (↑ urination)

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12
Q

Profile of Patient with Type I Diabetes Mellitus

A
  1. Thin, cannot gain weight
  2. Has episodes of hypoglycemia (confusion, diaphoresis, irritability, dizziness, headache, tremor)
  3. Is prone to complications from blood sugar being too high (diabetic ketoacidosis)
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13
Q

S/S of diabetic ketoacidosis (DKA)

A

Blood sugar of ↑ 250
Electrolyte imbalances
Dehydration
→Eventual coma

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14
Q

Type II Diabetes formerly known as?

A

Non-Insulin Dependent Diabetes- NIDDM)

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15
Q

% of Diabetes who are:

  • Type I
  • Type II
A

Type I: 10%

Type II: 90% of all DM

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16
Q

Type II Diabetes Cause by:

A

Insulin resistance and/or reduction in insulin production

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17
Q

Relationship between Type II Diabetes Mellitus and Insulin

A

THIS PERSON MAY NOT NEED INSULIN INJECTIONS

May be able to take an oral medication to stimulate the pancreas or decreases resistance to insulin

But may eventually need insulin (injections)→ During times of stress or illness (hospital) → Or with advanced age/disease

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18
Q

Onset of Diabetes II

A
  1. Slow onset of symptoms during adulthood (50-60s)
  2. Slow onset- takes years
  3. Onset of 3P’s but very slowly
    • Polydyspia (↑ thirst)
    • Polyphagia (↑ hunger)
    • Polyuria (↑ urination)
19
Q

Patient Profile of Patient with Type II Diabetes

A
  1. Often obese
  2. Has hyperglycemia
  3. Symptoms start more slowly
  4. Rarely has hypoglycemia
  5. Not prone to complications from hyperglycemia until glucose is over 600
  6. Many go undiagnosed (50%)
20
Q

Think about how our judgements affect our care

A
  1. Unfortunately we associated patients with Type II Diabetes as being fat and lazy
21
Q

Normal Blood Sugar is?

A

70-120 mg/dl

22
Q

How is medical insulin made?

A
  1. Most insulin is a synthetic copy of human insulin (DNA technology) = Humulin
  2. Formally taken from pigs and cows
23
Q

Insulin mechanism of action

A
  1. Control the storage & metabolism of carbohydrates, fats, and proteins
  2. Binding receptor sites on cellular plasma membrane especially liver, muscle, and fat tissue
24
Q

Goal of insulin therapy:

A
  1. Replace insulin to keep glucose levels as normal as possible
  2. Avoid complications of too much or too little insulin
25
Q

Insulin Administration

A
  1. Insulin MUST be injected to work
  2. Insulin is destroyed by the HCl in the stomach
    • There is no such thing as oral insulin
    • IV, SQ, & via insulin pumps
26
Q

Lispro or Aspart

A

Speed of Action: Immediate (Extremely fasting acting)

Onset: 5-15 min.
Peak: 1-2 hrs.
Duration: 4-6 hrs.

Markings on Bottle:

  • Pink op
  • Says Lispro or Aspart
27
Q

Which type of insulin that you don’t give before breakfast is served or blood sugar will drop; give with breakfast

A

Lispro or Aspart

28
Q

Regular Insulin

A

Speed of Action: Short acting

Onset: 30-60 min.
Peak: 2-4 hrs.
Duration: 6-10 hrs.

Markings on Bottle:
-Has “R” on the bottle with an orange top

29
Q

NPH

A

Speed of Action: Intermediate acting

Onset: 1-2 hrs. (slight onset)
Peak: 4-8 hrs.
Duration: 10-18 hrs.

Markings on Bottle:

  • Has an “N” on the bottle with orange top
  • Cloudy solution
30
Q

Glargine (Lantus)/ Determir (Leviemer)

A

Speed of Action: Steady
*Slow acting, slow and steady, helps keep a consistent blood sugar

Onset: Often give once a day 1-2 hrs. (slight)
Peak: None-steady
Duration: 24 hrs.

Markings on Bottle:

  • Taller bottle
  • Clear liquid
31
Q

Insulin Sliding Scales

Ex. If BS is 250-265, give X units of insulin

A
  1. MD orders for insulin based on blood sugar readings

2. Individually tailored for each patient

32
Q

Oral Antidiabetic Agents’ Actions

A

(Depending on type)

  1. Stimulates insulin secretion from the beta cells of the pancreas
  2. Helps with insulin resistance
  3. Enhance the action of existing insulin in the muscle, liver, and fat tissue (increased uptake)
  4. Prevent the live from breaking down the existing insulin as fast.
33
Q

Oral Antidiabetic Agents & Type I Diabetes

A

Note: Cannot be used exclusively for Type I- not the same as “oral insulin”

*Type I diabetics need insulin injections to survive

34
Q

Number of Oral Antidiabetic Agents

35
Q

Sulfonylureas Drug Type

A

Oral Antidiabetic Agents (Earliest Drugs Made)

36
Q

Sulfonylureas Action

A

Oral Antidiabetic Agents

Actions:

  1. Stimulates inclusion production in beta cells
  2. Increases the action of existing insulin
  3. Prevents the liver from destroying insulin
37
Q

Sulfonylureas S/E

A

Oral Antidiabetic Agents

S/E: can cause hypoglycemia

38
Q

Sulfonylureas Drug to Remember:

A

Oral Antidiabetic Agents

Glucotrol (Glipizide) – comes in an XL acting form too

39
Q

Glucotrol (Glipizide)

A

Oral Antidiabetic Agents
– comes in an XL acting form too

Type: Sulfonylureas- earliest drugs made

Actions:

  1. Stimulates inclusion production in beta cells
  2. Increases the action of existing insulin
  3. Prevents the liver from destroying insulin

S/E:
1. Can cause hypoglycemia

40
Q

Biguanides Drug Type

A

Oral Antidiabetic Agents- newer medication

41
Q

Biguanides Action

A

Oral Antidiabetic Agents

Action: decrease the production of glucose

42
Q

Biguanides S/E

A

Oral Antidiabetic Agents

S/E: Won’t cause hypoglycemia

43
Q

Biguanides Drug to Remember

44
Q

Metformin

A

Biguanides (Oral Antidiabetic Agents)

Action: decrease the production of glucose

S/E: Won’t cause hypoglycemia

Pharmacology (4 decks)

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