Endocrine Meds Flashcards
Rapid Acting Insulin
Aspart ( Novolog)
Lispro (Humalog)
Glulisine (aspidra)
Onset: 5-15min
Peak: 1-3 hrs
Duration: 3-5 hrs
Admin with meals.
Monitor for hypoglycemia, hypokalemia, lipodystrophy
Always have oral carb available
May be give short rermUV therapy
Anterior Pituitary
Stimulant Drugs
Somatropin (Genotropin, Serostim,
Nutropin)
Growth hormone replacement. Indicated for the treatment of growth failure due to growth hormone deficiency, AIDS wasting syndrome and short bowel syndrome.
*Contraindicated for treatment of growth failure after closure
of the epiphyseal plates.
- Common Adverse effects include: HA, hyperglycemia,
hypothyroidism, and ketosis.
Short Acting Insulin (Regular)
Common examples: Humulin R, Novolin R,
- Onset: 30 minutes to 1 hour, Peak: 2-4 hours, Duration: 6-8 hours.
- Used for dosing patients with Sliding Scale
- Can be administered IVP or via continuous infusion.
- Monitor for hypoglycemia, hypokalemia, lipodystrophy.
Intermediate Acting Insulin
Common examples: Isophane suspension (NPH,
Humulin N, Novolin N)
- Onset: 1-1.5 hours, Peak: 6-12 hours, Duration: 18-24 hours.
- Cloudy suspension. Can mix with Regular or Rapid Acting Insulin, draw up clear
(Regular or Rapid Acting) then cloudy (NPH), “Clear to Cloudy.” - Monitor for hypoglycemia, hypokalemia, lipodystrophy.
Long Acting Insulin
Common examples: Glargine (Lantus)
- Onset: 2-4 hours. No Peak, Duration: 24 hours.
- Once daily Subq injection provides 24 hour coverage.
- No peak, insulin delivered at steady level, less risk of hypoglycemia.
- Monitor for hypoglycemia, hypokalemia, lipodystrophy
- Always have oral carbohydrate available.
- DO NOT mix with any other insulin
Combination Insulin (Pre-mixed)
Common examples: Humulin 70/30, NovoLog
Mix 70/30 Humalog Mix 75/25, Humalog Mix
50/50,
- Intermediate Acting Insulin combined with either Rapid Acting or Short Acting
(Regular) Insulin. - Onset and Peak dependent on whether combined with a Rapid Acting or Short Acting
Insulin. All provide 24 hour duration. - Monitor for hypoglycemia, hypokalemia, lipodystrophy.
- Always have oral carbohydrate available
Anterior Pituitary Inhibitor
Drugs
Octreotide (Sandostatin)
Inhibits growth hormone, promotes fluid and electrolyte reabsorption. Indicated for the treatment of Acromegaly and severe diarrhea and flushing episodes associated with metastatic tumors.
- Common adverse effects include: Dysrhythmias, heart
failure, HA, hyper and hypoglycemia, GI complaints, fatigue
and dizziness, cholelithiasis
Posterior Pituitary Drugs
Desmopressin (DDAVP),
Vasopressin (Pitressin)
Indicated for the treatment of
Diabetes Insipidus and nocturnal
enuresis, normalizes urinary water
excretion.
- Antidiuretic hormone preparation
*Contraindicated in patients with DI that is caused by renal
disease as it can worsen fluid retention and overload - Potent vasoconstrictor, use with caution in patients with
known coronary artery disease or hypertension, and in
patients at risk for hyponatremia or thrombi - Monitor for signs and symptoms of water intoxication, ie:
HA, listlessness, drowsiness - Monitor intake and output.
Thyroid Hormone
Replacement Drugs
T4 Replacement: Levothyroxine
(Levothroid, Synthroid),
T3 Replacement:
Liothyronine (Cytomel, Triostat)
Indicated for the treatment of
hypothyroidism, myxedema and
cretinism.
take in morning 30 min before meals
*Common adverse effects include insomnia and weight loss.
*Serious adverse effects include: hypertension, tachycardia,
and cardiovascular collapse.
*Contraindicated with known cardiovascular disease
- Monitor for thyrotoxicosis.
tachydcardia , increased BP, angina, tremor, nervousenes, insomnia, heat intolerance - Replacement for hypothyroidism is life-long.
Sulfonylureas
tolbutamide (orinase) acetihexamide ( dymelor) chlorpropamide ( diabinese) tolazamide ( tolinase) glipizide ( glucotrol) glyburide ( diabeta) glimeppiride (amaryl)
stimulate release of insulin from pancreas
used for type II diabetes
Monitor for hypoglycemia ( take fast acting oral sugar)
take 15-30 minutes before meals
metformin (glucophage)
used for type II diabetes
decrease rate of hepatic glucose production and lowerg glucose reuptake by tissues
contraindicated for renal disease, heart failute, liver diesease
GI complaints ( DECREASED appetitie, nausea, diarrhea)
increase vb12 and folic acid in diet
Avoid alcohol
DO NOT SKIP ARE ADD DOSES
DO NOT STOP
Insulin Nursing Considerations
Clear before cloudy
rotate sites within an area (abdomen preferred)
NPH can be mixed with short acting
WATCH HYPOGLYCEMIA
store unopened vials in refrig, current vial rm temp for 1 month
