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Pharm Chapter Exam 2 materials > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the basic action of insulin?

A

Promote use of glucose by body cells, store glucose as glycogen in muscles

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2
Q

What are the uses of insulin?

A

reduce blood glucose, control diabetes mellitus

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3
Q

What interactions should you be aware of with insulin?

A

It can increase glucose when taken with thiazides, glucocorticoids, estrogens, and thyroid drugs

It can decrease glucose with aspirin, oral anticoagulants, tricyclic anti-depressants, and Monoamine oxidase inhibitors

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4
Q

What are the insulins listed as Rapid-acting insulin?

A

insulin lispro, insulin aspart, insulin glulisine, oral inhalation insulin

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5
Q

What are the onset, peak and duration of Rapid-acting insulin?

A

Onset of action: 15-30 mins

Peak at 30-90 mins

Duration 3-5 hours

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6
Q

What is the insulin that is classified as short-acting insulin?

A

Regular insulin

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7
Q

What are the onset, peak, and duration of Short-acting insulin?

A

Onset: 30 mins

Peak: 2.5-5 hours

Duration: 4-12 hours

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8
Q

What insulin is classified as Intermediate-acting insulin?

A

insulin isophane NPH

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9
Q

What are the onset, peak, and duration of Intermediate-acting insulin?

A

onset: 1-2 hours
peak: 4-12 hours
Duration: 14-24 hours

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10
Q

Which type of insulins are clear and which are cloudy?

A

Cloudy = insulin NPH

Clear= Rapid acting, short acting and Long-acting insulin

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11
Q

What insulin is classified as Long-acting insulin?

A

Insulin glargine

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12
Q

What are the onset, peak, and duration of Insulin Glargine?

A

Onset: 1-1.5 hours

No peaks

Duration: 24 hours

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13
Q

When should long-acting insulin be administered?

A

At bedtime

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14
Q

What are combination insulin and what are the different combination insulin types?

A

Combination insulins are made up of either short and intermediate-acting or rapid and intermediate acting insulin

Two types:

NPH 70/Regular 30

NPH 50/regular 50

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15
Q

True or false. Oral antidiabetics can be given to Type 1 Diabetics.

A

ONLY TYPE 2!!

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16
Q

What is the physiology of Type 1 Diabetes?

A

Autoimmune Beta Cell destruction.

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17
Q

What is the medication needed by Type 1 diabetics?

A

Exogenous insulin

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18
Q

What is the physiology of Type 2 diabetes?

A

Progressive loss of Beta cell insulin secretion alongside insulin resistance.

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19
Q

What is the medication(s) needed by Type 2 diabetics?

A

Oral diabetic agents, injectables, and insulin

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20
Q

What drug class is metformin?

A

Antidiabetic/Biguanides

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21
Q

What is the MOA of metformin?

A

Decrease hepatic production of glucose from stored glycogen.

It can also increase insulin receptor sensitivity

It DOES NOT CAUSE DROP IN GLUCOSE. ONLY PREVENTS RISE IN BLOOD GLUCOSE

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22
Q

What antidiabetics are often used by a financially unstable patient?

A

Metformin and sulfonylureas

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23
Q

What is the major contraindication of metformin?

A

Renal impairment due to risk for lactic acidosis

24
Q

A patient on metformin is scheduled for a procedure involving contrast dye. What should the nurse be aware of?

A

Metformin should be held 48 hours before and after procedure with contrast dye due to risk of lactic acidosis or renal failure

25
Q

What lab values should you look for with a patient on metformin with suspicions of renal impairment?

A

Look for creatine levels at or above 1.4 mg/dL. Normal is 0.6 to 1.3 mg/dL.

If at 1.4 mg/dL, reduce or stop metformin treatment and contact physician.

26
Q

What drug is considered a sulfonylurea?

A

glipizide

27
Q

What is the MOA of glipizide?

A

Directly stimulates the beta cells to secrete insulin

28
Q

What is the onset and peak of glipizde?

A

onset is around 90 minutes. Peak is around 2-3 hours

29
Q

What are some ASE of glipizide that a nurse should be aware of?

A

hypoglycemia, weight gain

30
Q

What is the biggest side effect of glipizide that a nurse should look out for?

A

hypoglycemia.

31
Q

If a patient is allergic to sulfa antibiotics, should the nurse give sulfonylurea to the patient?

A

NO

32
Q

What drug is considered as Incretin Modifier (DPP4 inhibitor)?

A

sitagliptin phosphate

33
Q

What is the MOA of sitagliptin phosphate?

A

Increases level of incretin hormones, which increases insulin secretion and decreases glucagon secretion to reduce glucose production

34
Q

What other activities are planned alongside sitagliptin phosphate?

A

Exercise and diet to reduce fasting and post-prandial plasma glucose levels.

35
Q

What drug is considered as a Glucagon-like Peptide 1 agonist (GLP1)?

A

Dulaglutide

36
Q

What is the MOA of Dulaglutide?

A

Enhancement of glucose-dependent insulin secretion, slowed gastric emptying, and reduction of postprandial glucagon and food intake.

37
Q

What are the ASE of Dulaglutide?

A

GI distress and hypoglycemia and weight loss

38
Q

What drug is considered as a Selective Sodium-Glucose Transporter 2 (SGLT-2)?

A

Empagliflozin

39
Q

What is the MOA of Empagliflozin?

A

To promote the renal excretion of glucose

40
Q

What are the contraindications of Empagliflozin?

A

GFR <45, history of DKA

41
Q

What are the ASE of Empagliflozin?

A

Candidiasis (aka genital yeast infections), cystitis (bladder infection), hypoglycemia, hypotension

42
Q

What should the nurse monitor for when giving Empagliflozin?

A

BP due to possible ASE of hypotension.

43
Q

What should the nurse teach to a patient taking Empagliflozin?

A

Teach patients to be well hydrated, teach that frequent urination at the beginning of drug therapy is normal.

44
Q

What drug is considered as a Thiazolidinedione (TZD)?

A

rosiglitazone

45
Q

What is the MOA of rosiglitazone?

A

Decrease insulin resistance and improve blood glucose control.

46
Q

Is rosiglitazone indicated for monotherapy?

A

No. It is usually taken alongside other medications.

47
Q

What is rosiglitazone contraindicated for?

A

Class 3 and Class 4 Heart failure due to dose-related fluid retention.

48
Q

What drug is considered a Meglitinide?

A

Repaglinide

49
Q

What is the MOA of Repaglinide?

A

Stimulate beta cells to release insulin

50
Q

What are the contraindications for Repaglinide?

A

Liver failure which causes decreased liver metabolism rate which can lead to drug accumulation and hypoglycemia.

51
Q

What drug is considered as an Alpha-Glucosidase Inhibitor?

A

Acarbose

52
Q

What is the MOA of Acarbose?

A

Inhibits digestive enzymes in the small intestine responsible for the release of glucose from the complex carbs in the diet.

53
Q

Does Acarbose cause hypoglycemia?

A

No, it delays glucose release which then reduces post-prandial hyperglycemia.

54
Q

When should Acarbose be given to a patient?

A

For patients that can’t handle their Diabetes with just diet alone

55
Q

What is the drug that is classified as a Hypoglycemic Drug?

A

Glucagon.

56
Q

What is the MOA of glucagon?

A

Increase Blood glucose.

57
Q

When is a hypoglycemic drug used?

A

For hypoglycemic episodes.

Pharm Chapter Exam 2 materials (6 decks)

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