Endocrine - Diabetes Mellitus

Question 1

Oral Antibietics

Answer 1

1 chlorpropramide + glipizide

2 metformin

Question 2

metoformin

Answer 2

• biguanides class

- most common type + 1st line of med for new Dx of DMof insulin bc no risk of HYPOglycemia

Question 3

metoformin

MOA

Answer 3

• incr insulin sensitivity
• decr absoptionof glucose in GI tract
• decr release of GLUCAGON fr liver

Question 4

metoformin

A/E

Answer 4

lactic acidosis

• wt loss
• dysgeuusia
• lowes B12>pernicious anemia

Question 5

metoformin

CI

Answer 5

• ETOH

- renal impairment

Question 6

***metoformin

RN/teaching

Answer 6

• stop before + after 48 hrs w/in CT scan w contrast
• —may use until again w normal BUN/Cr
• —-may cause lactic acidosis if not held

-take w meals

Question 7

chlorpropramide + glipizide

MOA

Answer 7

incr insulin release fr pancreatic beta cells

Question 8

chlorpropramide + glipizide

AE

Answer 8

photosensitivity, dizzy, HYPOglycemia

Question 9

chlorpropramide + glipizide

CI

Answer 9

• ***ETOH (disulfran: N/V flushing palpitation)
• type 1 DM
• DKA

Question 10

chlorpropramide + glipizide

RN

Answer 10

• daily dosing
• 30 min before meal
• ***no ETOH!

Question 11

Insulin

Tx

Answer 11

• incr glucose uptake into cells

- incr K uptake into cells

Question 12

Insulin

AE

Answer 12

• lipodystrophy
• hypoglycemia
• hypo-K
• wt gain

Question 13

Insulin

CI

Answer 13

ETOH

Question 14

Insulin

RN

Answer 14

• subQ back of arm, umbilical area

- rotate injection sites

Question 15

RAPID-ACTING - Insulin

drug names

Answer 15

lispro
aspart
glulisine

Question 16

SHORT-ACTING - Insulin

Answer 16

regular

humulin

Question 17

INTERMEDIATE-ACTING - Insulin

Answer 17

NPH

Question 18

LONG-ACTING - Insulin

Answer 18

glargine

detemir

Question 19

R, S, I, L Insulin

onset, peak duration

Answer 19

.....ONSET....PEAK....DUR
R 15-30m....30m-3h...3-5h
S 30-60m......1-5h......5-10h
I    1-2h...........6-14h.....16-24h
L  
70+m........NONE......24h

Question 20

Total Parenteral Nutrition

Tx

Answer 20

• colon CA
• colon surgery
• chemotherapy
• malabsorption
• paralytic ileus
• mechanical bowel obstruction
• acute pancreatitis
• Crohn’s disease

Question 21

Total Parenteral Nutrition

RN/teaching

Answer 21

• expect won’t be able to eat for longer > 7 days
• START SLOW, DON’T STOP ABRUPTLY (if stop, hang D10%W instantly)
• TPM is0.2 micron filter, lipids is 1.2 micron filter
• CHANGE TUBING Q24 hrs TPN; Q12 hrs lipids (bacteria loves glucose)

Question 22

Total Parenteral Nutrition

MOA

Answer 22

60-70% glucose

Question 23

Total Parenteral Nutrition

AE

Answer 23

hyperglycemia

–get insulin/heparin in bag; liver failure, ileus, infection

Question 24

Banana Bag

Tx

Answer 24

• for ETOH + certain malnutrition patients
  wernicke’s encephalopathy
  -korsakoff syndrome

has multi vitamins, folic acid, B vits, thiamine, magnesium

Question 25

for unconscious patients that are HYPO

Answer 25

IM glucagon

Question 26

for conscious patients that are HYPO

Answer 26

4 ox OJ, 15g carb, 2 oz grape

Question 27

give TPN thru a ___

Answer 27

filter