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DM Flashcards

1
Q

Diabetes insipidus is a disorder of what

A

the posterior pituitary gland

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2
Q

Which type of diabetes is an autoimmune disorder

A

Type 1

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3
Q

Which type of diabetes is the pt insulin dependent

A

Type 1

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4
Q

Which type of diabetes is causes the destruction of insulin secreting beta cells

A

Type 1

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5
Q

Which type of diabetes commonly begins in children

A

Type 1

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6
Q

What Causes type 1 diabetes

A

Auto immune, genetic, viral infections

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7
Q

What is the most common type of diabetes

A

Type 2

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8
Q

Which type of diabetes causes insulin resistance and decrease in insulin production

A

Type 2

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9
Q

Which type of diabetes results from a decreased number of insulin receptors on cells

A

Type 2

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10
Q

What is the onset of type 2 diabetes

A

> 30 y/o

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11
Q

What is the onset of type 1 diabetes

A

10-14 y/o

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12
Q

What are the risk factors of type 2 diabetes

A

Family HX
obesity (sedentary lifestyle)
pregnancy
aging

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13
Q

What is the long-term damage of chronic diabetes

A

eyes-blindness
kidney failure
nerves
heart disease
blood vessels- stroke
Amputation

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14
Q

What population is more At risk for DM 2

A

Hispanics
African-Americans
Native Americans

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15
Q

What does pre-prandial mean

A

Before meals

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16
Q

What does post prandial mean

A

After meals

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17
Q

What is the normal glucose level preprandial

A

80–130

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18
Q

What is the normal glucose level post prandial

A

< 180

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19
Q

What is a normal hemoglobin A-1 C

A

< 5.7%

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20
Q

What is a prediabetic hemoglobin A-1 C

A

5.7% - 6.4%

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21
Q

What is a diabetic hemoglobin A1c

A

> or = 6.5%

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22
Q

A hemoglobin A-1 C measures how far back

A

3 months

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23
Q

BS level for hypoglycemia

A

< 70

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24
Q

BS level for hyperglycemia

A

> 250

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25
Q

What are the 3 P’s associated with hyperglycemia

A

Polyuria
Polydipsia
Polyphagia

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26
Q

Normal blood sugar

A

70 - 100

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27
Q

S/S of hypoglycemia

A

Nervousness, anxious, irritable
Confusion- coma (severe)
Hunger, shaky
Tachycardia, palpations
Weakness, dizzy
Sweating
Cool, clammy skin

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28
Q

S/S hyperglycemia

A

Nausea
Dehydration
Blurred vision
Alert-coma
Rapid RR
Fruity odor of breath
Warm moist skin

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29
Q

What is the prototype of sulfonylureas

A

Glyburide (2nd gen)

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30
Q

What is the half-life of glyburide

A

10 hours

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31
Q

What is the onset of glyburide

A

45 to 60 minutes

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32
Q

What is the classification of glipizide

A

Sulfonylureas

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33
Q

What is the onset of glipizide

A

15-30 min

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34
Q

What is the half life of glipizide

A

2.1-2.6 hours

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35
Q

How long before breakfast do you give glyburide

A

45- 60 min

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36
Q

How long before breakfast do you give glipizide

A

15-30
Because absorption is delayed with food

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37
Q

Which sulfonylurea is preferred in Geri’s
And why?

A

Glipizide
Because it it shorter acting

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38
Q

Teaching for sulfonylureas

A

Dont give if unable to eat/ NPO
Weight gain may occur

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39
Q

MOA of sulfonylureas

A

stimulate the release of insulins from beta cells
increases insulin sensitivity to insulin at receptor sites
- may also decrease glucose output from liver

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40
Q

What med is best to start with for a pt who has never taken a BG medication before

A

Metformin (glucophage)

41
Q

What is the classification of metformin

A

Biguanides

42
Q

What is the MOA of metformin

A

Decrease the amount of glucose made by the liver and decrease GI glucose absorption

43
Q

Labs to watch for metformin

A

BUN/Cr
GFR

44
Q

Is metformin protein binding

A

No

45
Q

What adverse effects does metformin cause

A

Weight loss

46
Q

Does metformin cause hypoglycemia

A

No!

47
Q

Pt teaching for metformin

A

Avoid alcohol
Give with meals
Withheld when using contrast/ anesthesia:
- until kidney function is established

48
Q

What is the prototype of thiazolidinediones

A

Rosiglitazone (Avandia)

49
Q

Rosiglitazone (Avandia) MOA

A

Stimulate receptors of muscle, fat, and liver cells to keep insulin circulating

50
Q

How long does it take Rosiglitazone to reach max effect

A

12 weeks

51
Q

What is the peak of Rosiglitazone

A

1 hr

52
Q

What is the half life of Rosiglitazone

A

3-4 hours

53
Q

What labs do you watch for in pts taking Rosiglitazone

A

ALT
AST
ALP

54
Q

Caution is needed in what kind of pts taking Rosiglitazone

A

Pts with HF

55
Q

Pt teaching for Rosiglitazone

A

Take with meals, if you skip meals-skip med too

56
Q

What is the prototype for meglitinides

A

Repaglinide (Prandin)

57
Q

What is the MOA of repaglinide

A

Lowers blood glucose by triggering release of insulin from beta cells
- stimulated by food intake to increase meal related insulin secretion

*does not cause continued release of insulin

58
Q

Onset of repaglinide

A

30 min

59
Q

Peak of repaglinide

A

1 hr

60
Q

Half life of repaglinide

A

1 hr

61
Q

How long does it take for repaglinide to be removed from the body

A

3-4 hrs

62
Q

Caution for repaglinide

A

Liver impairment

63
Q

What is the prototype of DDP-4 inhibitors

A

Sitagliptin (Januvia)

64
Q

What is the MOA of sitagliptin

A

Increases incretin (GLP-1) levels
Inhibits glucagon release
Increases insulin secretion

65
Q

What is the onset of sitagliptin

A

RAPID

66
Q

What is the peak of sitagliptin

A

1-4 hrs

67
Q

What is the duration of sitagliptin

A

24 hrs

68
Q

What is the half life of sitagliptin

A

12.4 hrs

69
Q

Adverse effects of sitagliptin

A

Respiratory tract infections
(Ex: stuffy or runny nose)
Headache, hypoglycemia

70
Q

Cautions for sitagliptin

A

Caution in pts with :
pancreatic disease (pancreatitis)
HF
Renal impairment

71
Q

What does DDP-4 enzyme do

A

In-activates GLP-1

72
Q

What does GLP-1 do

A

Stimulate insulin release
Inhibit glucagon release

73
Q

What regulates BS levels

A

Insulin
Glucagon

74
Q

What is the MOA of insulin

A

Stimulate glucose uptake
Inhibit hepatic glucose production

75
Q

What is the route of insulin

A

Subcut
IV: regular only

76
Q

Safety concerns for insulin

A

Needs to be double checked by 2nd RN
- dont expose to heat or light: room temp for 1 month

77
Q

Rapid acting insulin

A

Aspart (novolog)
Lispro (humalog)

78
Q

Short acting insulin

A

Regular

79
Q

Intermediate acting insulin

A

NPH

80
Q

Long-acting insulin

A

Glargine

81
Q

O-P-D
LISPRO/ASPART

A

15 min
1-2 hr
3-4 hr

82
Q

Sliding scale insulin

A

Aspart/lispro

83
Q

What must be present when giving aspart/lispro insulin

A

Food trays

84
Q

What is the prototype of short acting insulin

A

Regular insulin

85
Q

O-P-D
REGULAR INSULIN

A

30-60 min
2-4 hr
5-7 hr

OPD time is different with IV

86
Q

What else can regular insulin be used for

A

Hypokalemia
Infuse insulin and glucose: shift K back into cells

87
Q

Most common S/S of hypoglycemia

A

Fatigue
Weakness
Irritability
Dizziness
Headache
Shaky

88
Q

Which insulin do you give between meals and as overnight coverage

A

NPH

89
Q

O-P-D
NPH

A

2-4 hr
4-10 hr
10-16 hr

90
Q

Which insulin do you never mix

A

Glargine

91
Q

O-P-D
GLARGINE

A

3-4 hrs
None
24 hrs

92
Q

Glargine trade name

A

Lantus

93
Q

Hypoglycemia treatment

A

<70 BS
Assess LOC/ ability to swallow
Check BS
Simple carbs or Glucagon 1 mg subcut/IM or 50% glucose 50 mL IV
Re-check BS
Notify MD
Determine cause

94
Q

Pt teaching regarding hypoglycemia management

A

Keep record of BS, diet, insulin, exercise
S/S
Have candy on hand
Importance of quick intervention to prevent CNS damage

95
Q

Med used in unconscious hypoglycemic pts

A

Glucagon
As an emergency TX/ insulin overdose

96
Q

Of label use of glucagon

A

Propranolol overdose
Beta Adrenergic antagonist - beta blocker

97
Q

Route of glucagon

A

Subcut
IM
IV

98
Q

Which med is not protein binding
Don’t check

A

Metformin

DM (1 decks)

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