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Pharmacology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Humalog, Novolog, and Afeeza are what type of insulin?

A

 Rapid acting

Onset: 15 to 30 minutes

Peak: 1 to 3 hours

Duration: 3 to 5 hours

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2
Q

What are administration considerations for rapid acting insulin?

❌Humalog, Novolog, and Afeeza❌

A

Administer within 15 minutes before a meal or immediately after a meal

🙅🏻‍♀️ Afeeza (inhaled insulin) contraindicated with patients who have asthma or COPD

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3
Q

All insulins can cause hypoglycemia and hypokalemia, but Afeeza can also have what adverse side effect?

A

Acute bronchospasm

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4
Q

The therapeutic affect for all types of insulin is what?

A

Maintain serum blood glucose levels within normal range

Achieve individualized target level of A1C, often 7%

Call HCP if BGL is over 250 or per facility protocol

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5
Q

Humulin R and Novolin R are what type of insulins?

What is their peak, onset and duration?

A

Short acting insulin

Onset: 30 minutes

Peak: 3 hours

Duration: 8 hours

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6
Q

Specific administration considerations for short acting insulin?

Humulin R and Novolin R

A

Administer 30 minutes before a meal

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7
Q

Humulin N and Novolin N are what type of insulin?

A

Intermediate acting insulin

Onset: 1 to 2 hours

Peak: 6 hours

Duration: up to 24 hours

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8
Q

Specific administration considerations for intermediate acting insulin:

Humulin N and Novolin N

A

Administer one to two times daily

Only subcutaneously

Roll/invert gently vial or pen before administration

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9
Q

Combination: intermediate acting/rapid acting insulin are:

❌first % is intermediate and second % is rapid acting❌

A

Humalog mix 50/50

Humalog mix 75/25

Novolog mix 70/30

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10
Q

Combination: intermediate acting/short acting insulin include:

What are the onset, peak and duration of the meds?

A

Humulin 70/30 & Novolin 70/30

Onset: 30-90 mins

Peak: 1.5 - 6.5 hours

Duration: 18-24 hours

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11
Q

Long acting insulin includes what medications

What are there onset, peak, duration?

A

Lantus and Levemir

Onset: 3-4 hours

Peak: none

Duration: greater than 24 hours

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12
Q

Hyperglycemic medication used to treat extremely low blood sugar when the patient is NPO?

A

Glucagon.

Admin sub cue, IM or IV

Supplement carbohydrates when patient is able to consume food safely. Especially PEDIATRIC patients

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13
Q

Sulfonylureas (Glipizide) stimulates insulin secretion from beta cells of pancreatic islets. This medication is given to help reduce what?

A

Reduce fasting blood sugar, and A1c to near normal

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14
Q

Sulfonylureas administration considerations ?

A

Time with meals

Peak plasma concentrations occur 1-3 hours after admin

Side effects: hypoglycemia

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15
Q

Biguanide (metformin) is an
Antihyperglycemics. It decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity.

How does metformin differ from Sulfonylureas? 

A

Metformin does not produce hypoglycemia

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16
Q

Metformin administration considerations:

A

Contraindicated in renal and hepatic disease.

Should be discontinued in patients undergoing radiologic studies involving contrast material.

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17
Q

Metformin therapeutic effects?

A

Reduce fasting blood sugar and A1C to near normal

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18
Q

Metformin adverse reactions include:

A

Stop immediately if signs of lactic acidosis, any condition associated with hypoxemia or dehydration

Diarrhea, nausea, vomiting, flatulence, abdominal discomfort, headache

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19
Q

 Metformin patient teaching

A

Take medication at same time each day to help control episodes of hyperglycemia

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20
Q

DPP-IV inhibitor (sitagliptin) increases insulin release and decreases glucagon levels in bloodstream.

What are the admin considerations?

A

Can give with or without food

Adverse reactions include: hypersensitivity (skin blisters/erosion) headache, pancreatitis, heart failure, upper respiratory infection.

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21
Q

 Levothyroxine is a thyroid replacement drug used to treat hypothyroidism.

What thyroid hormone does this medication simulate?

A

Synthetic T4 hormone

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22
Q

Levothyroxine administration considerations

A

Take with full glass of water on an empty stomach. 30 minutes to an hour before breakfast and at least 4 hours before or after any other drugs

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23
Q

Levothyroxine adverse reactions or side effects include:

A

Hypersensitivity reactions and cardiac dysrhythmias

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24
Q

Anti-thyroid (PTU) is used to treat hyperthyroidism or ameliorate symptoms of hyperthyroidism in preparation for thyroidectomy or radioactive iodine therapy.

This medication does what?

A

Inhibits the synthesis of thyroid hormones

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25
Q

PTU anti-thyroid medication administration

A

Given at 8 hour intervals

May cause hypothyroidism…..monitor TSH and T4 levels 

Notify HCP if patient becomes pregnant

26
Q

PTU anti-thyroid medication side effects/adverse reactions include:

A

Hypothyroidism, liver failure, agranulocytosis, fetal harm

27
Q

Calcitonin is used to treat osteoporosis

What are administration consideration?

A

It is administered VIA nasal spray with one spray in one side of the nose daily.

Contraindicated during pregnancy

Discard unrefrigerated bottle after 30 days of opening

The store unopened bottles in refrigerator until expiration date

28
Q

Calcitonin side effects/adverse reactions include:

A

Serious hypersensitivity reactions (Angioedema)

Hypocalcemia

Nasal mucosa adverse effects 

29
Q

Bisphosphonates (Alendronate) is used for prevention and treatment of osteoporosis in postmenopausal women and men with loss of bone mass

 What are some administration consideration?

A

Administered every eight hours at least 30 mins before first food, beverage or medication of the day.
Take only with water !!!!!

Patient should sit upright or stand for 30 minutes after administration

 contraindicated in pregnancy, hypocalcemia, and kidney disease 

30
Q

Bisphosphonates (Alendronate) enhances bone mineral density in osteoporosis, but has what adverse side effects?

A

Upper G.I. Tract adverse events, severe musculoskeletal pain (jaw)

31
Q

Symptoms of hypoglycemia:

A

Shaky, sweaty, hungry, sleepy, weak, confused, argumentative, dizzy

32
Q

Symptoms of hyperglycemia:

A

Fatigue, lethargic, glycosuria, polyuria, polyphagia, polydipsia, itchy skin

33
Q

What should you do for blood glucose levels below 50?

A

Check LOC and follow facility protocol

34
Q

Type 1 diabetes occurs because?

A

An autoimmune condition that affects beta cells in the pancreas.

Doesn’t produce insulin at all !!!!

35
Q

How does type 2 diabetes occur?

A

Usually due to lifestyle

Body cells become resistant to affects of insulin

36
Q

Labs that should be monitored in patients with diabetes?

A

Hemoglobin A1C (Aka: glycated hemoglobin)

Accuchecks (blood glucose meters)

Urinalysis (looking for ketones)

Lipid panels (cholesterol & triglycerides)

Eye exams (changes to retina)

Bun and creatinine (kidney)

37
Q

Signs of hyperthyroidism?

A

Skinny, can’t gain weight, tremors, fatigue, abnormal heart rhythm, insomnia, puffy eyes

38
Q

Signs of hypothyroidism?

A

Fatigue, sensitivity to cold, weight gain, constipation, dry skin, hair loss, delayed growth in puberty

39
Q

Basal insulin

A

 Can be long or intermediate acting

40
Q

Prandial insulin

A

Used with meals

Maybe rapid or short acting

41
Q

Insulin may come from humans and animals. What are the two animals?

A

Porcine and bovine

42
Q

insulin pump admin considerations?

A

Usually is regular insulin

Wearable device that should be moved and replaced every 3 days

Administered subcutaneously and continuously

Preferred placement for better absorption are in the abdomen and low back. 

43
Q

Iodine deficiency causes a condition called?????

A

Goiter = increased levels of TSH causes enlarged thyroid in neck

44
Q

Diabetic teaching points?

A

Signs/symptoms of hyperglycemia and hypoglycemia

BGL over 250 contact HCP

Dietary recommendations

No alcohol-decreases insulin effectiveness

When you exercise, you may need to decrease insulin dose

A1c labs done every 3 to 12 months

Check blood glucose levels regularly

45
Q

Treatment for hypoglycemia?

A

Glucagon, glucose tablets, dextrose, orange juice, candy, honey

46
Q

Hyperglycemia causes and treatment

A

Not enough insulin, stress, steroids

Treatment = insulin

47
Q

Adrenal cortex hormones include:

A

Aldosterone and cortisol

48
Q

Adrenal medulla hormones include

A

Epinephrine and norepinephrine

49
Q

Pancreas hormones include

A

Insulin and glucagon

50
Q

Thyroid hormones include

A

Calcitonin, T4, T3

51
Q

How does insulin affect potassium levels?

A

All insulin products cause a shift in potassium from extracellular to intracellular space which can lead to hypokalemia.

52
Q

foods that are high in iodine

A

Shellfish, cod, sardines, tuna, eggs, seaweed, kidney beans, chickpeas, milk, baked, potato, yogurt, prunes

53
Q

What drug class can cause osteoporosis?

A

Glucocorticoids

54
Q

What is the best practice for giving combination insulin injections?

A

Give TWO separate shots. Do not mix in same syringe.

55
Q

After giving insulin subcutaneously, how long should you leave the needle in the skins before retracting?

A

Five seconds

56
Q

important patient teaching education for giving injections?

A

Syringes, sharps container, vantage point needles.

57
Q

What should patients know about taking beta blockers and their glucose levels?

A

Monitor blood glucose levels more closely.

58
Q

Fasting blood glucose levels

A

70 to 100

59
Q

A1c test measures average blood sugar level over past 2 to 3 months what A1c is considered normal ?

A

Below 5.7%

60
Q

The stress response triggered by illness, will result in an increase the creation of what hormones?

A

Cortisol, glucagon and growth

61
Q

When insulin therapy is indicated the healthcare provider may choose from several preparation’s based on what reasoning?

A

Insulin is prescribed based on the clients likelihood of long-term recovery

62
Q

New patient is diagnosed with hypothyroidism 

Diagnostic testing as indicated that the clients health problem is caused by anterior pituitary dysfunction

 The clients hypothyroidism is rooted in a deficiency of

A

Thyroid stimulating hormone

Pharmacology (6 decks)

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