Diabetic Drugs Flashcards
Three P’s of diabetes
Polyuria
Polydipsia
Polyphasia(hunger)
Cultural occurrence of diabetes
Increased in:
- African American
- Native American
- Hispanic
Finger stick
Blood serum
60-100
70-110
Anything over 180 spills out into urine
Type 1 diabetes
Insulin dependent
“Juvenile” onset-lack of insulin production
Type 2 diabetes
Non-insulin dependent Most commonly found in older adults Obesity Body produces some insulin but not enough Or could be insulin resistant
Gestational diabetes
Occurs during pregnancy
May subsid
Secondary diabetes
-stress response due to increased cortisol levels=increased blood sugar
DKA
Dehydration is biggest issue IV fluids:NS Possible insulin pump Hourly accu-check Monitor electrolytes
Hemoglobin A1C
Monitors past three months
Less than 7% in diabetics less than 5% in non(greater than 6.5 is a concern)
Insulin
Promotes the uptake of glucose, amino acids, fatty acids and converts then to substances that are stored in body cells(lover and stomach
If mixing mix clear to cloudy
Beta cell secretion of insulin in pancreas
Rapid acting insulin
Onset:5-15 minutes
Duration:2-5 hours
Peak:one hour
eat immediately
logs
Short acting insulin
Onset:30 min
Duration:6-8 hours
Peak:2-4 hours
Only type of insulting that can be given SQ&IV
Ex: Humulin R, Novolin R
Intermediate acting insulin
Onset:1-2 hours
Duration:18-24 hours
Peak:6-12 hours
Ex:Humulin N/Novolin N
Ex: Humulin L/Novolin L
Levemir is intermediate acting and long acting
Long acting insulin
Lasts:12-24 hours
Never peaks
Ex:Lantus
SE of insulin
Hypoglycemia: nervousness,tremors, perspiration
Give sugar or IV glucose
Ketoacidosis hyperglycemia reaction
Extreme thirst Polyuria Fruity breath Kussmaul breathing Rapid thready pulse Blood sugar above 250
Insulin pen
No fridge for a month
Causes higher compliance with patient
Insulin pump
Subcut needle that tapes in place
Secretes rapid acting insulin
Dial in bolus before meals
Oral anti-diabetics
Can’t give to type one
Sulfonylureas: stimulate insulin production
Second generation sulfonylureas
Onset:15-30 min Peak:1-2 hours Lasts 24 hours glipizide(glucotrol) NO ALCOHOL Excreted through kidneys Highly protein bound Similar side effects to insulin
Patient teaching
Teach patient to know and report S/S of hypoglycemia,and hyperglycemia(Thirst,DKA, Increased urine output, fruity breath)
Teach patient to carry medic alert card,tag, or wrist band with health issue and insulin dosage u
Biguanides
Most type 2’s on this
Metformin(glucophage)
Decreases hepatic production of stored glycogen
With old for 48 hours before and after the client has IV contrast dye(lactic acidosis or acute renal failure may occur)
Excreted through kidneys, not metabolized by liver
Thiazolidinediones
Decrease insulin resistance and improves blood glucose control
Rosiglitazone(avandia)
WARNING:heart disease patients
Can cause severe fluid retention
Take on empty stomach
Alpha-glucosidase inhibitors
Breakdown the glucose after meals and store it away
These drugs inhibit digestive enzymes
