Endocrine Medications Flashcards
Classification of Oral Glucose
Caloric Agent
Action of Oral Glucose
A simple monasaccharide used to increase circulating blood glucose levels
Indications for Oral Glucose
Conscious patients with suspected hypoglycemia
Contraindications for Oral Glucose
- Unconscious
- Hyperglycemia
Adult Dose of Oral Glucose
25 g PO q 5 mins, max 50 g
Side Effects of Oral Glucose
- Nausea
- Vomiting
Pharmacokinetics of Oral Glucose
Onset: 5-15 mins
Duration: Varies
Considerations for Oral Glucose
- Must be swallowed. Not absorbed sublingually
- A complex carbohydrate must be given to prevent relapse after hypoglycemia is corrected
Classification of Dextrose - D50W
Caloric Agent
Actions of Dextrose- D50W
- Rapidly increases serum glucose levels
- Hypertonic solution producing a transient movement of water from interstitial spaces into venous system
Indications for Dextrose- D50W
Hypoglycemia with altered LOC, low BGL
Contraindications of Dextrose- D50W
- Allergy to corn/corn products
- Hyperglycemia
- Hypersensitivity
Adult Dose for Dextrose- D50W
Hypoglycemia: 25g SIVP/IO q 5 mins, titrate to BGL >/= 4.00 mmol/L pr patient improvement, max 50g
Suspected Stroke: 12.5g SIVP/IO q 5 min prn, titrate to BGL >/= 3.00 mmol/L or patient improvement, max 50 g
Suspected head injury: 12.5 g SIVP/IO q 5 min prn, titrate to BGL >/= 4 mmol/L or patient improvement, max 50 g
Pediatric Dose for Dextrose
Less than 10kg: 0.5g/kg D10W SIVP/IO q 5 min prn, titrate to BGL >/= 4mmol/L or patient improvement
More than 10kg an less than 40kg: 0.5g/kg D25W SIVP/IO to single max dose of 12.5 g q 5 min, titrate to BGL >/= 4mmol/L or patient improvement
More than/ equal to 40kg: 12.5 g D50W SIVP/IO q 5 min prn, single max dose, titrate to BGL >/= 4mmol/L or patient improvement
Side effects of Dextrose- D50W
- May aggravate hypertension and CHF
- May cause neurological symptoms in the alcohol patient (Wernicke’s encephalopathy, Korsakoff’s Syndrome)
Pharmacokinetics of Dextrose- D50W
Onset: <1 min
Duration: Varies
Considerations for Dextrose- D50W
- Other carbohydrates must be given to prevent relapse after hypoglycemia is corrected
- At least an 18 g IV needle has to be used with a NS bag
Precautions with Dextrose- D50W
- Suspected intracranial hemorrhage, CVA (Half the dose in this case)
Classification of Glucagon
- Hormone
- Hyperglycemic agent
Action of Glucagon
- Increases BGL by stimulating glycogen breakdown in the liver, converting glycogon to glucose
- Excreted by the alpha cells of the pancreas
- Causes smooth muscle relaxation
- Positive inotropic and chronotropic effects
Indications for Glucagon
Altered LOC when confirmed hypoglycemia and IV is unable to be established
Contraindication for Glucagon
- Hyperglycemia, Hypersensitivity
- Pheochromocytoma- may stimulate the release of catecholamines from the tumor resulting in sudden increase of BP
- Hypersensitivity to pork or beef products
Adult Dose of Glucagon
1mg IM q 15 min prn, max 2 mg
Pediatric dose for Glucagon
Less than 20kg: 0.5mg IM q 15 min prn, max 1 mg
More than/equal to 20kg: 1 mg IM q 15 min prn, total max
