Diabetes/Insulin Flashcards
action of amylin
works with insulin to lower glucose and delay emptying
increases sensation of satiety (person feels full and stops eating/consuming more carbs)
surpresses glucagon secretion (stops the body from releasing more sugar)
stimulates insulin release (getting rid of the blood glucose thats already there)
glucagon action
hormone that causes glycogen to break down energy –> hyperglycemia
glucogen
storage form of glucose
long term effects of diabetes
angiopathy PVD peripheral vascular dx retinopathy neuropathy infections
signs and symptoms of diabetes
polyphagia polydipsia 3Ps polyuria fatigue UTI's
hemoglobin a1c should be at
under 6
fasting blood glucose
under 100
prediabetes blood glucose
100-125
diabetes blood glucose
over 125
route insulin therapy is given
IV (IV push for severely hyperglycemic)
subQ
inhaled
What type of insulin can we use for needle-phobic people?
Insulin Human (afreeza)
insulin pump (is just one needle)
how will type I diabetics use afreeza
use with a long-acting insulin
how will type 2 diabetics use afreeza?
use in combination with oral anti diabetic therapy
(Notes: Type II receives oral therapy because their hyperglycemia can be caused by other reasons than their beta cells not working)
which is the only insulin i can give VIA IV?
Humulin R
Which is the insulin that cannot be mixed with any other insulin?
Glargine (Lantus)
dawn phenomenom
Early morning spike in blood sugar which can be frustrating to the patient, in spite of them not eating at night
(leaves patient feeling discouraged)
Which two things interfere with early morning spike?
*TEST Q
Dawn phenomenom
Somogyi phenomenom
what type of insulin would we use for supplemental insulin coverage?
Insulin Regular (novolin R)
what do Sulfonylureas do?
SE?
increase secretion of insulin
(can only be effective if theres functioning beta cells)
pt education: monitor for s/s for hypoglycemia
think: since ur increasing insulin production
alpha-glucosidase inhibitor action
delay glucose absorption in GI tract causing smaller increase post prandially (
anti-hyperglycemic drug, why?
type?
metformin- b/c it increases glucose use by muscle and fat cells
type: biguanide
SE of glitzaones (thiazolidinediones)**
risk of CHF and edema
CI for meglitinides
skip dose if u skip meal
which drug can i use that causes the growth of beta cells?
type
Sitagliptin (Januvia)
dipeptidyl peptidase-4 (DPP-4 Inhibitors)
which is the drug that causes you to urinate blood glucose?
type?
Empagliflozin (Jardiance)
Canaglifozin (invokana)
Dapagliflozin (Farxiga)
hint: it will be out in a jiffy, jif
sodium glucose transporter 2 inhibitor
which drug activates dopamine receptors in the CNS?
Bromocriptine (Clycoset)
neurotransmitter manipulation- IN BRAIN to control blood glucose
How often is eventide (byetta) given
daily
How often is Exematide ER (bydureon) given
once a week
subQ
amylin drug type
SE
Pramlintide (symlin)
nausea and hypoglycemia
Reminder: amylin delays gastric emptying (not going in the SI where glucose is absorbed)
creates sensation of fullness
route Pramlintide (Symlin) is injected
subcutaneous injection
do not mix in the same syringe with insulin
What type of medical condition can use an amylin analog?
type II diabetics
type II diabetic with needle eversion can use
Pramlintide (symlin)
how often is Victoza (liraglutide) taken
what type of drug is it
daily
VA= daily TTO= weekly
GLP
how often is Adlyxin (lixisenatide) taken?
daily
VA= daily TTO= weekly
Which are the types of GLPs need to be taken weekly
Trulicity (Dulaglutide)
Tanzeum (albiglutide)
ozempic (semaglutide)
SE of GLP’s
risk of GLP’s
hypoglycemia, weight loss
Thyroid CA, pancreatitis
Xultopgy (IDeglira) is a combination ____(drug type), composed of ___ and ____
GLP
Tresiba
Victoza (liraglutide)
Soliqua (Lixilan) is a combination drug ____ (drug type), composed of ___ and ____
Lantus (insulin glargine)
Adlyxin (lixisenatide)
(Hint: Lauras initials)
Causes hyperglycemia
Bee pollen
Gingo biloba
glucosamine (impaired beta cell function)
How can we treat DKA?
NS for dehydration**
insulin IV drip
post up patient meds
insulin with IV dextrose
how is glucose gel administered?
buccal
pt education for sulfonylureas
pt education: monitor for s/s for hypoglycemia
which type of diabetic can use sulfonylureas
type 2- can only work if person has functioning beta cells
metformin (type?)
CI?
fever sepsis trauma major surgery acidosis hepatic/renal dx CV ot respiratory insufficency hypoxia lactic acidosis
how often is metformin given
1-2 times a day
Januvia type
action
blocks an enzyme that degrades insulin
beta cell neogenesis
CI for DD4 drug?
example of drug
Januvia
cannot take with exogenous insulin
CI of sodium glucose cotransporter 2 inhibitor
hypoglycemia
DKA- monitor carefully!
Dopamine Receptor Agonist- name of drug?
CI?
Bromocriptine (Clycoset)
taper*
*Do not use with ergot drugs
Dopamine Receptor Agonist- name of drug?
SE?
Bromocriptine (Clycoset)
Decreases fatty acids, Decreased bp
dec triglycerides
dizziness
GI symptoms
