Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > diabetes > Flashcards

diabetes Flashcards

1
Q

what is endogenous insulin and where is it secreted from?

A

it is a protein hormone that is secreted by beta cells in the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where is endogenous insulin secreted into?

A

the portal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

adults secrete ____ units insulin/day

A

40-60 units a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

half of insulin secreted into liver is ____, rest gets into system circulation

A

used or degraded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the insulin that does not combine with receptors is metb where?

A

liver, kidneys, plasma, and muscles. in the kidneys insulin is filtered by the glomeruli and reabsorbed by the tubules, which also degrade it. severe renal impairment slows the clearance of insulin from the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in the liver, the insulin acts to ____

A

decrease breakdown of glycogen (glycogenolysis) and form new glucose from fatty acids and amino acids (gluconeogensis) and form ketone bodies (ketogenesis)

as well as increase synthesis and storage of glycogen and fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

in adipose tissue what does insulin do?

A

decrease breakdown of fat (lipolysis) and increase production of glycerol and fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

in muscle tissue what does insulin do?

A

decreases protein breakdown and amino acid output and increases amino acid uptake, protein synthesis and glycogen synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does normal glucose metabolism entail?

A

after insulin binds on the cell membrane, glucose can move into the cell, promoting cellular metabolism and energy production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the major stimulus in regulation of insulin secretion?

A

glucose **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_____ in the GI tract stimulate the release of insulin when glucose levels are normal or elevated

A

incretin hormones **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cortisol, GH, epinephrine, estrogen and progesterone inc or dec blood glucose levels?

A

** inc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can enhaust pancreatic beta cells which can cause or aggregate DM?

A

excessive, prolonged endogenous secretion ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some factors that inhibit insulin secretion?

A

** hypoxia, hypothermia, surgery, and severe burns (stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when do growth hormones peak?

A

at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

chronic systemic disease means your FBG is what?

and your HgbA1c is what?

A

> 7mmol/l

> 6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what types of macrovascular problems might you have?

A

moderate and large vessels which present as hypertension, MI, stroke, and peripheral vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

changes in small blood vessels (microvascular) include what?

A

retina, kidney resulting in retinopathy, blindness and nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is HBA1c?

A

marker of average blood glucose for past 2-3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is type 1 DM?

A

autoimmune disorder that destroys pancreatic beta cells ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is type 2 DM?

A

insulin resistance and hyperglycemia**

22
Q

S&S of DM?

A

**hyperglycmie -> glycosuria-> polydipsia, polyuria, dehydration, polyphagia

23
Q

complications of diabetes?

A

MI, stroke, blindness, leg amputation and kidney failure **

24
Q

what are different types of exogenous insulin?

A

pork and human insulin

25
Q

what are some insulin analogs?

A

lispro and insulin aspart are **short acting

26
Q

what do some intermediate acting have added to it?

A

protamine and/or zinc

27
Q

insulin gangrene is what kind of insulin?

A

long acting used to provide basal amount

28
Q

when is the onset of rapid acting insulin? avg peak and duration?

A

10-15 min and peak around 1-1.5 and duration 3-5

29
Q

what kind of insulin is humulin R?

A

short acting so onset is 30 min

30
Q

what kind of insulin is humulin N?

A

intermediate so onset is 1-3 hours

31
Q

when mixing short and long acting- which do you draw up first?

A

draw up rapid then long so clear then cloudy

32
Q

lispro = what?

A

humalog

33
Q

glargine = what?

A

lantus

34
Q

what does sulfonylureas do? (glyburide)

A

increase secretion of insulin **, peripheral use of glucose and decrease gluconeogensis. may inc number of insulin receptors or alter post receptor actions

35
Q

what are alpha-glucosidase inhibitors? (acarbose)

A

they delay digestion of complex carbs into glucose. glucose absorption is delayed

36
Q

what does biguanide (metformin) do?

A

increase use of glucose ** by muscle and fat, decrease hepatic glucose production and dec intestinal absorption of glucose

37
Q

what does glutazones (actos) do?

A

insulin sensitizes decrease insulin resistance by stimulating receptors on muscle, fat, and liver cells **

38
Q

what do meglitinides (nateglinide) do?

A

stimulate pancreatic secretion of insulin **

39
Q

what does incretin agent (Dipeptidyl peptidase-4 (DPP-4) Inhibitors)
do?

A

stigliptin

increase beta cell neogenesis

40
Q

general action of oral anti diabetics ?

A

The drugs lower blood sugar by decreasing absorption or production of glucose, by increasing secretion of insulin, or by increasing the effectiveness of available insulin (decreasing insulin resistance)

41
Q

what do these natural health products do to blood glucose? bee pollen, ginkgo blob, glucosamine

A

increase

42
Q

what do beta blockers and alcohol do on blood glucose?

A

increase blood glucose with glyburide and metformin ***

43
Q

what natural health products decrease blood glucose?

A

basil, bay leak, chromium, cheinacea, garlic, ginseng, glucomannan, guar gum

44
Q

what can you combine sulfonylurea with in DMT2?

A

acarbose, metformin, and glitazone

45
Q

what can you combine metformin with for DMT2?

A

meglitinide and sulfonyurea again

46
Q

When a patient takes a combination of sulfonylurea and glitazone what action does the glitazone have?

a. Provides fixed-dose combinations
b. Allows for smaller daily doses of insulin
c. Increases insulin effectiveness
d. Increases insulin
A

ncreases insulin effectiveness

Rationale: The sulfonylurea increases insulin and the glitazone increases insulin effectiveness.

47
Q

Your patient is NPO for surgery at 10:00 h. He routinely receives 30 units of Humulin 30/70 every morning at 07:00 h. What is the appropriate nursing action in this situation?
Administer 30 units of Humulin 30/70 Subcut.
Hold the insulin because the patient is NPO.
Give the patient a light breakfast and administer the insulin as ordered.
Contact the physician for a pre-surgery insulin order.

A

D

Humulin 30/70 is regular insulin + NPH

48
Q 
Which of the following insulins cannot be administered in a continuous Subcut insulin infusion pump?
Regular insulin (Humulin R)
Insulin aspart (Novorapid)
Insulin glulisine (Apidra)
Insulin glargine (Lantus)
A

D

Regular insulin (Humulin R) short acting
Insulin aspart (Novorapid) rapid acting
Insulin glulisine (Apidra) rapid acting
Insulin glargine (Lantus) long acting
49
Q

D

Regular insulin (Humulin R) short acting
Insulin aspart (Novorapid) rapid acting
Insulin glulisine (Apidra) rapid acting
Insulin glargine (Lantus) long acting
A

B
Administer insulins:
Intermediate (NPH, humulin N, novolin N) gently mixed by rolling due to suspension

Draw up short-acting first, then intermediate, administer within 15 minutes

50
Q 
An older person with type 2 diabetes who takes metformin presents to the emergency department with symptoms of drowsiness, malaise, respiratory distress, and bradycardia. Which of the following problems should the nurse suspect is causing those signs and symptoms?
Hypoglycemia
Hyperglycemia
Lactic acidosis
Metabolic alkalosis
A

C
Lactic acidosis—drowsiness, malaise, respiratory distress, bradycardia and hypotension (if severe), blood lactate levels above 5 mmol/L, and blood pH below 7.35.

A rare but serious adverse effect (approximately 50% fatal). Most likely with renal or hepatic impairment, advanced age, or hypoxia. This is a medical emergency that requires hospitalization for treatment. Hemodialysis is effective in correcting acidosis and removing metformin.

51
Q 
The nurse should be especially alert to the adverse effect of hypoglycemia in a type 2 diabetic patient taking which of the following oral hypoglycemics?
Sulfonylurea
Alpha-glucosidase inhibitor
Biguanide
Thiazolidinediones
A

A

Because it causes increased insulin secretion

Pharm (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions