Diabetes Flashcards
1
Q
fasting glucose diabetic diagnosis
A
126 or greater
2
Q
2 hour 75 gram glucose tolerance test diabetic diagnosis
A
200 or greater
3
Q
hba1c % for diagnosis of diabetes
A
6.5% or greater
4
Q
prediabetes diagnosis a1c
A
5.7-6.4%
5
Q
random plasma glucose of ____ or greater can also diagnose diabetes
A
200 or greater
6
Q
diagnosis for gestational diabetes
A
two step strategy screening done 1) 50 gram oral glucose (non fasting) in 24th to 28th week of pregnancy, glucose measure after 1 hour -if value 140 or greater proceeds to 2nd step 2) full glucose tolerance test fasting! 100g sugar load test must meet 2 criteria -fasting >95 -1hour >180 -2 hour >155 -3 hour >140
7
Q
one step GDM diagnosis
A
75 gram OGTT at 24 - 48 weeks after an overnight FAST of at least 8 hours
diagnosis made if any of the following criteria are made
- fasting 92 or greater
- 1h 180 or greater
- 2h 153 or greater
8
Q
pre prandial goal
A
80-130
9
Q
post prandial goal
A
<180
10
Q
goal alc
A
less than 7
11
Q
microalbumin in the urine
A
<30mg/24hr is what you want
12
Q
eAG =estimated average glucose
A
6%=126
add 28.5 to get any other percent
13
Q
ace or arb in diabetics if
A
microalbuminuria >30 mg/day or eGFR <60 ml/min
14
Q
aspirin in diabetes in
A
history of stroke or MI
- 10 year risk score greater than 10 percent
- 50 or older with smoker, dyslipidemia, htn, FMH, albumineria)
15
Q
statins in diabetes if >40
A
if >40 yes
- no risk factors: moderate
- risk factors: high
16
Q
statins in diabetes less than 40
A
only if ascvd/ risk factors
17
Q
risk factors for statins in diabetes
A
LDL 200 or greater HTN, Smoker, albumineria, FMH of ascvd
18
Q
high int. statins
A
rosuvastatin (crestor) 20-40
atorvastatin (lipitor) 40-80
19
Q
diabetic eye exam
A
annually
20
Q
urine exam
A
annually
21
Q
foot exam
A
check each visit
check for pulse and infection
22
Q
diabetic foot infections
A
mild superficial infections (strep+mssa): cephalexin, dicloxacillin
if mrsa is a concern: doxy or bactrim
deeper infections add gram negative coverage and anaerobic coverage
23
Q
trim toenails straight
A
across and check feet everyday
24
Q
vaccines in DM
A
flu 6 months or older
pneumococcal 2 or older then again at 65
hep b age 19-59
25
hep b age
19-59
26
rapid acting insulins
lispro (humalog)
aspart (novolg)
glulisine (apidra)
27
rapid acting discard after
humalog
novolog
apidra
28 days
28
fiasp
insulin aspart works faster than other rapids (5 min quicker) 100u/ml
29
where to inject insulin
2 inch away from belly buttom
back of the arm
thigh
keep it in place, dont pull it out right away
30
rapids are used to
```
cover a meal
should be clear
onset 5-15 min
peak 1-2 hours
duration 3-5 hours
```
31
how many units of insulin are in a 3 ml pen
300 units
32
how many units of insulin are in a 10 ml vial
1000 units
33
who do you not use afreeza in
asthma/copd
34
afreeza is
rapid
35
effect of insulin on potassium
hypokalemia, brings potassium into the cell and out of the blood
used as a treatment for hyperkalemia
36
afreeza room temp for
unopened 10 days
opened strips 3 days
bring cartridge to room temp before using (10 min)
discard inhaler after 15 days
37
humulin R u-500
RX only!
5x as potent
vial 40 days
pen 28 days
38
humulin R and Novolin R are
```
regular insulins they are OTC
onset is 30 min
duration is 6- 8 hours
THey are CLEAR because of the R (R is for regular)
100u/ml
```
39
humulin R room temp discard after
31 days
40
novolin R room temp discard after
42 days
41
intermediate acting insulins are OTC
NPH
Humulin N
Novolin N
42
NPH=clear or cloudy
cloudy
43
humulin N discard after
31 days
44
novolin N R discard after
42 days (6 weeks)
45
intermediated acting onset and duration
onset 2 hours
peak 6 to 8 hours, consider a snack after 6 hours after the dose
duration 10-16 hours
46
in combo insulins the bigger number is the ___ acting
longer acting
47
glargine cannot be
mixed with any other insulin product
48
long acting insulins are RX
detemir (levemir)
glargine (lantus, toujeo, basaglar, semglee)
degludec (tresiba)
49
tresiba room temp for
56 days
50
detemir (levemir) room temp for
42 days
51
levemir/ detemir can be QD or __
BID
52
toujeo is U-
300
53
when switching from toujeo to basaglar
reduce dose by 20 percent
54
tresiba is only
once daily
55
detemir flex touch pen
prime 2 units insert, press, hold in for 6 sec
56
all insulin glargine are given
qd
57
lantus room temp
28 days
58
nph to detemir (levemir)
1:1
59
nph once daily to lantus or toujeo
1:1
60
nph twice daily to glargine u-100
decrease dose by 20 percent and give glargine once daily
61
long acting to nph
1:1 and give BID
62
toujeo u-300 to lantus, basaglar, or levemir(detemir)
decrease dose by 20 percent and give QD
63
insulin is given
SC
64
regular insulin can be given
IV IM or SQ
65
rotate injection site with insulin to avoid
lipohypertrophy (lump of fat under skin)
66
use shortest __mm and thinnest __-__gauge for insulin
4mm, 29-32
67
type 1 starting insulin
0.5 u /kg/day
68
type 2 starting insulin
0.1-2u/kg/day (start with basal)
69
check glucose if high can add 1 unit per __ mg/dl above glucose goal
50mg;dl
70
pramlintide(symlin)
both type 1 and type 2 used as an adjunct to patients who use meal time insulin
71
pramlintide (symlin) should only be used if the patient is already on
insulin
72
pramlintide is a ____ line measure due to risk of hypoglycemia and cost
3rd
73
do not give symlin to patients with
alc >9
hypersensitivity to metacresol preservative
gastroparesis or gi motility meds like reglan
74
pramlinitide makes you feel ___
full thus causes severe nausea can also cause anorexia and weight loss
75
MOA of symlin
a synthetic analog of human amylinm, a naturally occuring hormone made by pancreatic beta cells. amylin is secreted with insulin from beta cells and lowers post prandial blood sugars
76
other things that symlin (pramlinitide) does
1) delays gastric empyting
2) INHIBITS post prandial blood glucose release
3) reduces appetite/weight loss
77
pramlinitide dosing
t1dm: 15mcg sq tid immediately before meals
t2dm: 60 mcg sq tid immediately before meals
78
SE of pramlinitide
nausea, anorexia, weight loss, SEVERE hypoglycemia
79
symlin room temp
discard after 30 days
80
storage room temp 28 days
```
humalog
novolog
apidra
lantus
bydureon
```
81
storage room temp 30 days
symlin
byetta
victoza
82
storage room temp 31 days
humulin R/N combos
83
storage room temp 42 days
Novolin R/N combos
| Detemir (Levemir)
84
Room temp 56 days
glargine (toujeo)
85
10 days room temp pens
humalog mix
| humulin mix
86
14 day pen storage
novolog mix
| humulin N prefilled pen
87
28 day pen storage
novolin N flex pen
Humalog
Novolog
Lantus
88
42 day pen storage
Detemir (levemir)
89
hypoglycemia
blood sugar 70 or less
90
examples of fast sugar for hypoglycemia
```
5-6 life savers
2 cubes sugar
4 oz orange juice
6 jelly beans
3-4 glucose tablets
```
91
hypoglycemia and patient is unconcious
glucagon 1 mg sc/im/iv
or glucose (iv dextrose) if glucagon is unavailable
92
sick day management
insulin requirements increase with illness and infection
| patient must inject insulin and check glucose every 3-4 hours
93
DKA
usually insulin dependent
caused by illness or noncompliance
ask if insulin has been ski[[ed look for signs of infection
94
signs and symptoms of DKA
FRUITY BREATH!
| N/V, abdominal pain
95
how to treat DKA
hydrate: w/ 0/9% nacl
give insulin
give dextrose when glucose drops below 200 or 250
96
DKA tx
| DIABETES
D dehydrated- hydrate w NS
I insulin (regular insulin, IV 0.1 u/kg/hr)
A acidosis
B bicarbonate
E electrolytes (monitor k, mg, po4, hco3)
T Time
E Electrolytes
S Sugar (when glucose drops below 200 or 250)
97
if hypoglycemic at 3am how to fix
symogi effect
| decrease bedtime NPH
98
if hyperglycemic at 3am how to fix
dawn phen.
| not decreasing insulin
99
hypoglycemia causes an increase in
NE and EPI
side effects make sense
sweating tachycardia
100
biguanide
metoformin
101
sulfonylureas
glimepiride
glipizide
glyburide
102
meglinitides
"glinides"
repaglinide (prandin)
nateglinide (starlix)
103
thiazolidinedones
"glitizones"
rosiglitizone
pioglitizone
104
GLP1 agonists
```
"tides"
liraglutide
lixisenatide
exenatide
semaglutide
```
105
dpp4 inhibitors
```
"gliptins"
sitagliptin
alogliptin
linagliptin
saxagliptin
```
106
SGLT2 inhibitors
"gliflozoins"
- canagliflozin
- dapaglifolzin
- empagliflozin
- ertugliflozin
107
alpha glucosidase inhibitors
acarbose
| miglitol
108
dopamine agonist
bromocriptine (cycloset)
109
Metformin (biguanide) names
```
glucophage
glucophage XR
fortamet
glumetza
riomet
```
110
metformin MOA
decrease hepatic glucose production
decreases intestinal absorption of glucose
improves insulin sensitivity
111
metformin does not cause
- hypoglycemia
- weight gain
it causes weight loss and favorable lipid effects
112
glucophage max dose
2550 mg.day
113
fortamet max
2500 mg.day
114
glucophage XR max dose
2000 mg/day
115
glumetza max dose
2000 mg/ day
116
metformin SE
```
nausea
low appetite---weight loss
diarrhea--take w food to decrease upset stomach
decrease vit b12
lactic acidosis
metallic taste
PREG CAT B
```
117
metformin CI in eGFR
30, initiation not rec. w eGFR 30-45
118
D/C metformin before an iodinated contrast imaging procedure in patients with egfr <60 or history of
liver disease
alcoholism
HF
119
sulfonylureas MOA
increase insulin secretion from pancreatic beta cells
120
sulfonylureas SE
weight gain due to increase insulin
hypo glycemia due to increase insulin
take with first meal of the day
121
metformin does not
secrete insulin
122
metformin/pioglitazone
actoplus met
123
metformin/sitagliptin
janumet
124
metformin/canagliflozin
invokanamet
125
ER formulations of metformin leave a
ghost tablet
126
lactic acidosis risk increases with
renal disease
127
1st line in pregnancy
insulin
128
glimepiride brand
amaryl max 8 mg
129
glipizide brand
glucotrol/ glucotrol xl use if renal impaired
130
glyburide brand
glynase (do not use in renal or hepatic impairment)
131
___ and ___ sulfonylureas are on the beers criteria for patients that are >65
glyburide and glimepiride, use glipizide (glucotrol) for patients greater than 65
132
Amaryl (glimepiride)
1-2 mg QD max 8 mg
metabolized 100 percent by the liver
safe in renal failure , dose must be reduced- glipizide is first choice
133
Glucotrol (glipizide)
```
max dose 20 mg BID (40 mg QD)
glipizide ER (glucotrol xl): max 20 mg qd - oros ghost tablet
```
DOC in RENAL and elderly if using a sulfonylurea
IR- TAKE 30 min before first meal of day
134
Glynase (glyburide)
high risk with elderly becuase it is sooo long acting avoid in patients 65 or older
do not use in renal or hepatic failure
135
repaglinide brand
prandin
136
nateglinide
starlix
137
meglinide MOA
stimulate insulin secretion from beta cells
| mostly affect postprandial glucose
138
meglinides SE
weight gain
hypoglycemia
dose adjust in renal impairment
139
most important thing with meglinides (prandin, starlix) (repaglinide, nateglinide)
if a meal is missed or added omit or add a dose accordingly, give before meals :)
140
pioglitazone
actos ( i p when i act)
141
rosiglitazone
avandia
142
tzds MOA
insulin sensitizers
| increase skeletal muscle cell sensitivity to insulin
143
TZDs boxed warning
avoid with heart failure
144
TZDs warnings
hepatic failure
edema
can cause or worsen heart failure
bone fractures
can stimulate ovulation (may need contraception)
avoid with history of bladder cancer (pioglitazone)
145
which TZD increases lipids
rosiglitazone (avandia)
146
which tzd decreases TGs
pioglitazone (actos)
147
dont give TZDs with
insulin
148
liraglutide brand
victoza QD
149
lixisenatide
adlyxin QD
150
exenatide
byetta BID
151
exenatide ER
bydureon once weekly
152
dulaglutide
trulicity once weekly
153
semaglutide
ozempic once weekly
154
semaglutide
rybelsus tabs PO QD
155
GLP1 agonists "tides" MOA
1. slows down gi motility
2. decrease appetite- weight loss
3. decrease glucagon
4. increase insulin
156
GLP 1 agonist SE
```
G- gi symptoms, gall bladder disease
L-weight Loss
P-pancreatitis
1- thyroid tumors- boxed warning
A- acute renal failure and chronic renal failure exacerbation
```
157
do not use GLP1 with
DPP4, so no tides with gliptins
158
boxed warnings for GLP1s "tides"
do not use if personal family hx of medullary thyroid cancer (MTC)
do not use if hx of multiple endocrine neoplasia (MEN2)
159
saxenda max
| victoza max
saxenda weight loss 3 mg
| victoza DM 1.8 mg
160
must dispense needles with
byetta, victoza, adlyxin
161
needles are provided with
weekly insulin
162
dulaglutide is given
once weekly
163
bydureon, trulicity, ozempic come with or without needles
with
164
do you give GLP 1s in end stage renal disease
no
165
exenatide (byetta) is given
BID (6 hours apart) 60 min before meals
166
exenatide CI in crcl
<30
167
exenatide ER (bydureon, bydureon BCise) given
weekly must mix either 15 sec or 80 sec
168
trulicity (dulaglutide) given
once weekly
| room temp 14 days
169
semaglutide (ozempic and rybelsus)
ozempic (SQ once weekly)
| rybelsus (tabs) 3mg then up to 7-14 mg after 30 days
170
rybelsus special things
take on empty stomach
| store in original pack
171
byetta/bydureon CI
GFR <30
172
victoza avoid in (liraglutide)
ESRD
173
adlyxin avoid in
crcl <15 ESRD
174
ozempic (semaglutide) no dosage adj nes. in
renal impairment
175
trulicity avoid in
ESRD
176
DPP 4 Inhibitors (gliptins) are usually
add on therapy
177
dpp 4 Is
```
SALSa:JNTO
Sitagliptin: januvia
Alogliptin: Nesina
Linagliptin: tradjenta
Saxagliptin: onglyza
```
178
sitagliptin brand
januvia
179
alogliptin brand
nesina
180
linagliptin brand
tradjenta
181
saxagliptin brand
onglyza
182
SE with DPP ivs gliptins
```
joint Pain (arthralgia)
Pancreatitis
```
183
how to take DPPIVs
with or without food
184
brands together DPPIVs (4)
januvia
nesina
tradjenta
onglyza
all are oral!
185
DPP4 MOA
1. Pancreas: GLP1 and GIP cause increase insulin release and decrease glucagon release both leading to decrease blood glucose
(inhibit you from metabolizing GLP 1, so you have more of it)
2. liver: decrease release of glucose
3. feeling of fullness: reduce food intake
4. slow down the absorption of glucose from the GI
186
DPP4 on weight
neutral
187
dose adjust all dpp 4s except
linagliptin (tradjenta)
188
avoid saxagliptin (onglyza) and alogliptin (nesina) in
HF
189
linagliptin (tradjenta) can be given in
RENAL
190
4 drugs to not given in HF
saxagliptin, alogliptin, rosiglitazone, pioglitazone
191
which two DPP 4s are cyp 3a4 substrates
linagliptin (tradjenta)
| saxagliptin (onglyza)
192
janumet, janumet XR
sitagliptin+metformin
193
all SGLT2s are
QD in the morning! or will be peeing all night
194
canagliflozin
invokana
195
empagliflozin
jardiance
196
dapaglifozin
farxiga
197
ertugliflozin
steglatro
198
sglt2 brands together
invokana
jardiance
farxiga
steglatro
199
SGLT2 side effects
S
G- genital yeast infections
L-increase Ldl, Lower weight, Lower BP, Labs: increase K, mg, po4
T-bone fracTures
Once daily in the morning
* KETOACIDOSIS (peeing out sugar)
* Necrotizing Fascitits
-diuretic effect (weight, bp)
200
SGLT2s work on the
proximal renal tubule to increase glucose excretion
201
benefits of canagliflozin
reduces cv events, ckd progression, HF
(good for kidneys and heart)
black box warning for increase risk of lower limb amputations
202
flozins are CI if crcl is less than what
30
203
invokana (canagliflozin) do not use if CRCL less than
30
204
canagliflozin dose (invokana)
100 mg QD before first meal
| can increase to 300 mg qd before first meal
205
invokamet
canagliflozin/metformin
206
canagliflozin (invokana) cautions
```
increase scr
genital yeast infections
weight loss
hypotension
increase LDL
increase potassium
bone fracTures
hypoglycemia - not alone but when combined with insulin or secretagoues
ketoacidosis
necrotizing fascitits
increase risk of lower limb amputations
```
207
flozins protect the ___ like aces
kidneys
| it has renal protection!
208
watch sglt2s with other meds that increase
potasssium
209
stop sglt2s 3 days before
surgery, to decrease risk of ketoacidosis
210
dapagliflozin not recommend in crcl less than
45
211
xigduo
dapagliflozin/metformin
212
dapagliflozin is FDA approved for ___ as an adjunctive agent for patient with reduced ejection fraction with or without diabetes
HF
can use this for heart failure they dont have to have diabetes to use it
213
ertuglaflozin do not use if egfr is less than
60
214
empagliflozin (jardiance) reduces what
major cv events and progression of HF and CKD
215
alpha glucosidase inhibitors
1
2
acarbose (precose)
| migitol (glyset)
216
alpha glucosidase inhibitor MOA
inhibit alpha glucosidase enzymes of the proximal SMALL INTESTINE BRUSH BORDERS
prevent the breakdown of polysaccarhides (sucrose) to monosaccharides (glucose and fructose)
do not prevent but delay absorption
* BIND TO SUCROSE*
- if you skip a meal skip this
217
acarbose brand
precose
218
migitol brand
glyset
219
alpha glucosidase inhibitor if hypoglycemic on these take ___ or ___ not ___
fructose or lactose
not sucrose
the sucrose will just bind and not get absorbed
so no table sugar!
orange juice and milk okay
220
bromocriptine (cycloset) increases what
dopamine, it's also used in parkinsons
221
wouldnt give bromocriptine or cycloset in ___
schizoprenia
222
bromocriptine inhibits the production of
MILK
| avoid in lactating mothers
223
increasing dopamine decreases
prolactin
224
cinnamon helps with
type 2 diabetes
| not for long term only short term 4 months
225
decrease in b12 gives what type of anemia
macrocytic anemia
226
2nd line therapies after metformin for diabetes
sulfonylureas: hypoglycemia and weight gain
glitazones: actos and avandia (weight gain, fluid retention, HF, liver failure, decrease bone density)
insulin: recommended for initial therapy when fasting glucose if over 250 or a1c is 9-10 can also be an add on
227
when to initiate insulin first
fasting glucose over 250
OR
a1c 9-10
228
For patients who are close to their a1c gaol but have high post prandial glucose:
```
meglitinides: do not use with sulfonylureas
glp 1 agonists: lose weight
dpp4 inhibitors: weight neutral
sglt2: weight loss
alpha glucosidase inhibitors: GI SE
```
229
TZDs are through the
LIVER
230
diabetes in pregnancy gold standard
insulin
231
collagenase:santyl
topical ointment that uses enyzmes to remove dead skin and necrotic tisse from wounds and does not harm healthy tissue
232
rayos generic
prednisone
233
parlodel generic
bromocriptine for parkinsons and diabetes
234
dexilant generic
dexlansoprazole
235
can steroids and ppis increase the risk of bone fractures
yes
236
vials have how many units of insulin
1000 u
237
pens how many units of insulin
300 u
238
DM meds with CV benefit
liraglutide
canagliflozin
empagliflozin
239
DM meds with HF benefit
canagliflozin
empagliflozin
dapagliflozin
240
niacin (vitamin b3) can cause
hypergylcemia increase blood glucose
241
which meds can reduce insulin sensitivity in women with pcos
tzds and metformin
242
do not mix symlin (pramlinitide) with any
insulin
243
metformin is CI with active ___ disease and __ is checked at baseline
liver disease
| LFT
244
exenatide er can cause severe
skin lesions (nodules) injection site reaction
245
beta blockers block signs of hypoglycemia (shaking, anxiety, palpitations) but which two can still be present
sweating and hunger
246
DKA signs
fruit breath, N/V, BG greater than 250, ketones in the urine or blood, anion gap acidosis
247
what medication is CI in patients with gastroparesis
pramlinitde
248
type 1 diabetes has __ c peptide levels
low
249
quinolones can increase
blood glucose
250
target BG in the hospital
140-180
251
HHS causes severe
dehydration, most common in type 2, ketones not usually present in urine
252
hpyoglycemia what to treat
```
8 oz milk
3-4 glucose tabs
4 oz soda
4 oz oj
1 tbsp honey
1 serving glucose gel
```
15-20 grams of carbs
253
insulin available as 200u/ml
insulin lispro and degludec
254
medications that can cause drug induced diabetes
systemic steroids
protease inhibitors
antipsychotics
255
fat into ketones is
DKA
256
what test is used in pregnancy for testing for GDM
oral glucose tolerance testr
257
hypergylcemia can cuase
Microvascular:
retinopathy-vision loss
nephropathy- kidney impairment/failure
neuropathy- loss of feeling---amputations
autonomic neuropathy- erectile dysfxn, gastroparesis, UTIS
```
Macrovascular:
Atherosclerosis-ASCVD
CAD: including MI
CVA: including Stroke
PAD: amputations
```
*depression and DKA,HHS
258
3 Ps for hyperglycemia
other symptoms also
polyuria( increase urination)
polydypsia (increase thirst)
polyphagia (increae hunger)
fatigue, blurry vision, ED, vaginal fungal yeast infections
259
when to test for diabetes what age
45
| also test if one risk factor and bmi 25 or greater (physical inactivity is a risk factor lol)
260
a1c is measured every __ months if not at goal
3 months
| and 6 months if at goal
261
pre meal pregnant goal
95 or less
262
1 hour
2 hour
post meal pregnant goal
1 hour 140 or less
| 2 hour 120 or less
263
aspirin dose for DM
75-162mg usually 81mg
264
natural products for DM
cinnamon
alpha lipoic acid
chromium
265
If CVD major issue use:
dulaglutide, liraglutide, semaglutide
| If renal allows can use: empagliflozin, canagliflozin
266
HF or CKD major issue use:
empagliflozin, canagliflozin, dapagliflozin
if renal doesnt allow for that use
dulaglutide, liraglutide, semaglutide
267
never use what two together
glp 1 (tide) and dpp 4 (gliptin)
268
do not use ___ with heart failure
alogliptin (nesina) or saxagliptin (onglza)
269
how many units a day when starting a type 2 on it
10 units or 0.1 to 0.2 u/kg/dau at bedtime of basal
270
2 common things with metformin, GLP1s, and SGLt2s
weight loss and no hypoglycemia
271
byetta and adlyxin give within
60 min of meals other give anytim
272
symlin (pramlinitide) has a boxed warning for
| and its CI in
severe hypoglycemia
gastroparesis
decrease meal time insulin dose by 50%
used with meals
273
insulin does what to potassium
hypokalemia
274
hyperkalemia with
canagliflozin
275
renal insuffiency avoid (CRCL <30)
metformin, SGLT2I, exenatide, glyburide
276
can you use afrezza in smokers
no
277
increase risk of heart failure when taking rosiglitazone with ____ do not use together
insulin
278
inject rapids how many minutes before eating
5-15 min before
279
regular is injection how soon before meals
30 minutes
280
iv regular insulin should be given in what type of container
non pvc container
281
nph is
humulin N, novolin N
282
do not mix long actings with
any other insulin
283
toujeo has how many units per ml in the pen and comes in what pen sizes
300 u/ml
comes in 1.5 ml- 450 u/ml
comes in 3 ml- 900 u/ ml
284
insulin that comes concentrated
humalog kwikpen (lispro)- 200u/ml
humulin r u-500 kwik pen and vial- 500 u/ml
tresiba flex touch pen (degludec) 200 u/ml
toujeo solostar, max star pens (glargine) 300 u/ml
285
humulin r u-500 comes in a __ ml
20 ml and has 10,00 u of insulin
286
use 0.3 ml syringe for
up tp 30 units
287
use 0.5 ml syringe for
30-50 units
288
use 1ml syringe for
51- 100 units
289
beta blockers can cause
hypo or hyper glycemia
290
drugs that can cause hyperglycemia
```
thiazides and loops
tacrolimus, cyclosporine
protease inhbitors
quinolones
antipsychotics
statins
steroids
cough syrups
niacin
```
291
quinolones can cause
hypo or hyperglycemia
292
drugs that can cause hypoglycemia
```
linezolid
lorcaserin (belviq)
pentamidine
beta blockers
quinoloines
tramadol
```
293
tramadol and linezolid can decrease
blood glucose
294
hypoglycemia symptoms
```
dizziness
anxiety
irritability
shakiness
headache
diaphoresis (sweating)
hunger
confusion
nausea
ataxia
tremors
tachycardia
palpitations
blurred vision
```
295
severe hypoglycemia can cause
seizures coma and death
