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Pharma > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Components of the Endocrine System

A

Pituitary, thyroid, parathyroid, adrenal glands, pancreas, testes, ovaries, and placenta.

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2
Q

What does the pancreas produce and secrete?

A

Insulin and glucagon

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3
Q

What does the liver do?

A

Stores glycogen, releases it when the blood sugar is low.

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4
Q

Glycogenolysis

A

Conversion of glycogen to glucose in the circulating blood

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5
Q

What is the cause of diabetes mellitus?

A

Too little insulin production by the pancreas

Result of autoimmune response destroying the beta cells in the pancreas..

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6
Q

What is hyperglycemia?

A

Elevated blood sugar related to insufficient insulin.

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7
Q

What is hypoglycemia?

A

Low blood sugar below 70

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8
Q

Who’s at greater risk for developing diabetes?

A

a. MI
b. CVA
c. kidney disease
d. lower limb amputations

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9
Q

Type 1 Diabetes

A

no production of insulin by the beta cells. requires insulin daily for life.

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10
Q

What are the 3 P’s of Type 1 Diabetes?

A

Polydipsia- Increased thirst
Polyphagia- increased appetite
Polyuria- excessive urination.

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11
Q

Polydipsia

A

Increased thirst

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12
Q

Polyphagia

A

Increased appetite

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13
Q

Polyuria

A

Excessive urination

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14
Q

Other symptoms of Type 1 Diabetes

A

Weight loss despite enough caloric intake.

Glycosuria, blurred vision,fatigue

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15
Q

What does insulin do?

A

Hormones that Lowers blood glucose levels by helping glucose move into target tissues

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16
Q

Which type of diabetes does insulin treat?

A

Type 1

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17
Q

Type 1 Diabetes Treatment Regimen

A

Very strict diet.

Controlling simple and complex carbohydrates

Home glucose testing: 2- 4 times a day

Multiple insulin injection daily.

Planned activity daily. Exercise as tolerated.

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18
Q

What is Type 2 Diabetes?

A

The pancreas still has some ability to make insulin. Not enough to meet the demands of the body daily.

Non-insulin dependent diabetes.
Occurs after 40 years of age.

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19
Q

Type 2 Diabetes Risk Factors

A 
Obesity
Older age
 family history of diabetes.
History of gestational diabetes
Race/ ethnicity.
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20
Q

Treatment for Type 2 Diabetes

A

diet. Controlling simple and complex carbohydrates.
daily exercise
Use of one or more oral antidiabetic agents
Glucose monitoring.

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21
Q

Hypoglycemia

A 
Sudden onset
Less than 70 blood sugar
CNS: Fatigue, weakness, agitation, convulsion, dizziness unconsciousness.
Resp. Normal to rapid. Shallow.
GI: hunger, nausea
Skin: pale moist diaphoretic.
Pulse: normal or uncharacteristic
Numbness, tingling of tongue and lips
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22
Q

Hyperglycemia

A 
Gradual onset
More than 200
CNS: drowsiness, dim vision.
Resp. rapid. Kussmal, resps.
GI: thirst nausea, vomiting.
Skin: dry flushed ,warm
Pulse: rapid, weak./
Acetone breath. Fruity smell
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23
Q

Gestational Diabetes

A

Type of diabetes that develops during pregnancy. 2% out of 10 pregnancies.

Diet control/or insulin may be necessary to control blood sugars.

Approximately 30% of clients who develop gestational diabetes usually develop type 2 diabetes within 10-15 years.

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24
Q

Glycemic Goal of Treatment

A

Hemoglobin A1C is the lab value used to determine an index of controlled blood sugars from 2-3 months ago
The goal is less than 7%

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25
Q

A1C Less than 5.7

A

Normal

26
Q

A1C Between 5.7 and 6.4

A

Prediabetic

27
Q

A1C above 6.5

A

Type 2 Diabetic

28
Q

Onset (Insulin)

A

when insulin first begin to act in the body.

29
Q

Peak (Insulin)

A

Insulin at its highest point

30
Q

Duration (Insulin)

A

The length of time the insulin remains in effect

31
Q

What is a rapid acting insulin?

A

Lispro

32
Q

Lispro Onset, Peak, and Duration

A

Onset-15-30 minutes
Peak- 0.5-2.5 hours
Duration: 3 – 6 hours.

33
Q

What is a short acting insulin (regular)?

A

Humalog

34
Q

Humalog Onset, Peak, and Duration

A

Onset: 0.5-1 hr.
Peak: 1- 5 hours
Duration: 6 – 10 hours.

35
Q

What is an Intermediate Acting Insulin?

A

NPH Insulin

36
Q

NPH Insulin Onset, Peak, and Duration

A

Onset 1-2 hours
Peak : 6 to 14 hours
Duration: 16 to 24 hours.

37
Q

What is a long acting insulin?

A

Lantus or Levemir

38
Q

Lantus & Levemir Onset, Peak, and Duration

A

Onset: 70 minutes
Peak: none
Duration.18-24 hours

39
Q

What is insulin resistance?

A

develop antibodies against insulin in the body.

40
Q

Insulin drug precautions:

A

renal or hepatic impairment

Pregnancy

41
Q

Basal Bolus Insulin Therapy

A

Mimics the healthy pancreas.
delivers long acting insulin constantly to keep the blood glucose
Steady.
Allows for short acting insulin bolus to be delivered when the blood glucose elevates.

42
Q

Meal Bolus

A

to compensate for increased carbohydrates at each meal.

43
Q

Correction Boluses

A

when blood glucose levels are high and need to be brought down to a normal range

44
Q

Supplies needed to administer insulin:

A 
Insulin (Verify) 
Syringe
Alcohol wipe
Disposable gloves
Sharps container
45
Q

Oral Hypoglycemics Action

A

Stimulate insulin release from pancreatic beta cells; decrease insulin resistance

46
Q

Oral Hypoglycemics Uses

A 
Monotherapy versus combination therapy
Six classes
Biguanide
Alpha-glucosidase inhibitors
Meglitinides
Thiazolidinediones
Incretins
47
Q

Biguanides

A

Class of medications that treat Type 2 Diabetes

48
Q

Metformin

A

In the Biguanides class

Oral drug used for diabetic control of blood sugar.

Decreases glucose production by the liver. Newly diagnosed diabetics type 2

49
Q

When not to take metformin (Contraindicated)

A

If you have renal disease. As it is excreted by the kidneys.

Abdominal bloating, nausea, and or diarrhea

50
Q

Adverse Effects of Metformin

A

Abdominal bloating
Nausea cramping
Reduced vitamin 12
Metallic taste

51
Q

Glinides (ie. Prandin)

A

Class of drugs that treat Type 2 Diabetes

Stimulate the liver to be sensitized to circulating insulin levels, and hepatic glucose production.

In type 2 diabetes the liver may not detect levels of glucose in the blood, and may release glucose into the blood stream.

Prandin ( repaglinide)

52
Q

Thiazolidinediones (Glitazones) (ie Pioglitazone(Actos)

)

A

Insulin - sensitizing drugs.
Decrease insulin resistance by enhancing the sensitivity of insulin receptors.
Stimulate glucose uptake and storage. Inhibit glucose production in the liver.

53
Q

When not to take Thiazolidinediones

A

Heart failure/water retention

54
Q

A- glucosidase inhibitors (ie precose)

A

Treat Type 2 Diabetes

Lower blood sugar by delaying the digestion of carbohydrates in the intestine. Glucose absorption is delayed.
Used in combination with other oral hypoglycemic.
Abdominal discomfort, diarrhea

55
Q

Do not take A- glucosidase inhibitors if:

A

IBS/Malabsorption syndrome

56
Q

DPP-IV Inhibitor

A

Januvia ( sitagliptin)-
Glucose absorption in the intestine is delayed.
Increases beta cell production of insulin.
Suppresses glucagon production in the liver.

Must be taken with food.
High incidence of abdominal discomfort

57
Q

What is a Amylin Agonists Pramlintide SQ injection?

A

Used when glucose control fails with insulin alone.
Slows gastric emptying
Suppresses glucagon secretion
Increases satiety( feeling of having eaten enough)
Incretin Mimetic: (Trulicity)
Failed glucose control with oral antidiabetics.
Enhances glucose-dependent insulin secretion. Suppresses glucagon secretion.

58
Q

Sodium glucose Cotransorter Inhibitor( SGLT2 Inhibitor)

A

Prevents reabsorption of glucose in the tubule of the kidney.
causing glycosuria.
Decreasing glucose in the blood stream.

Invokana

59
Q

Glucose Elevating Drug

A

Glucagon IM injection for hypoglycemia.

Oral tablet forms of glucose that dissolve.

IV glucose. Can be administered in the hospital

60
Q

Teaching Strategies

A

Adequate balanced nutrition with adherence to diet.
Keep appointment with MD.
Maintain target goals for HGAIC less than 7%.
Understand signs an symptomsd of hypoglycemia
Hyperglycemia.
Notify MD when illness occurs so meds can be adjusted.

Pharma (3 decks)

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