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Felder > Endocrine Module 1 > Flashcards

Endocrine Module 1 Flashcards

1
Q

Alpha-Glucosidase inhibitor

A

Delays carbohydrate digestion and absorption

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2
Q

Biquanides

A

Reduce hepatic glucose production Increases insulin sensitivity to muscle and fat cells Reduce insulin resistance Decrease weight Improve lipid levels

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3
Q

Meglitinides

A

Stimulate insulin release from the pancreas

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4
Q

Thiazolidinediones

A

Decrease insulin resistance Increase insulin sensitivity

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5
Q

Dipeptidyl peptidase-4 inhibitor

A

Inhibits breakdown of increntin hormone

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6
Q

Increntin mimetic

A

Increase insulin secretions from beta cells Suppress glucagon secretion Slow gastric emptying

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7
Q

Amylinomimetic / amylin analogue

A

Slows the movement of food through the stomach

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8
Q

Sulfonylureas

A

Stimulate the beta cells to release insulin 30min b4 breakfast Check allergy to sulfa She’ll in stool

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9
Q

Acrabose (precose)

A

Alpha-Glucosidase inhibitor (Maltase)

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10
Q

Metformin (glucophage)

A

Biquanide

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11
Q

Miglitol (glyset)

A

Alpha-Glucosidase inhibitor (Maltase)

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12
Q

Glimepiride (amaryl)

A

Sulfonylureas

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13
Q

Glyburide (micronase)

A

2nd gen Sulfonylureas

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14
Q

Tolburamide (Orinase)

A

Sulfonylureas 1st gen

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15
Q

Pioglitazone (actos) Rosiglitazone (avandia)

A

Thiazolidinediones

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16
Q

Exenatide (byetta)

A

Increasing mimetic

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17
Q

Nateglinide (starlix) Repaglinide (prandin)

A

Meglitinide

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18
Q

Sitagliptin (januvia) Saxagliptin (onglyza)

A

Dipeptidyl peptidase 4 inhibitor

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19
Q

Pramlintide acetate (symlin)

A

Amylin analogue

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20
Q

Glipizide (glucotrol)

A

Sulfonylureas 2nd gen

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21
Q

Chloropropamide (diabenese)

A

1st gen sulfonylureas

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22
Q

Tolazamide (tolinase)

A

Sulfonylureas 1st gen

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23
Q

Sulfonylureas

A

Oral hypoglycemics Type 2 Stimulate beta cells to release insulin- effective but decreases effectiveness overtime Administer 30 min before breakfast Chlorpropamide (Diabimese) 100-250mg / day Glyburide (micronase) (diabeta) 2.5 mg- 20mg / day Glimepiride (amany) 1-8mg/day Side effects Hypoglycemia N+V, anorexia Weight gain Photo sensitivity Weakness Nephrotoxicity Hepatotoxicity (jaundice, pruitis) Interaction: sulfa, Asa, NSAID, phenytoin, Allopurinol, betablockers, maoi, antifungals, fluroquinolones Might find shell in stool

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24
Q

Alpha Glucosidase inhibitors

A

Oral H- type 2Carb blockers- delays carbohydrate digestion and absorption Aka Maltese- acts on maltose food products Only taken if they can eat- work in GI blocking digestion and absorption of carbs Take after the first bite Acarbose (precose) 25 100mg TID Side effects Abdominal pain Diarrhea / bloating Upset stomach Hypoglycemia Flatulence (gas) Treat with glucose tablet or glucose gel not w. food cause its not going to work Caution- liver and bowel disease

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25
Q

Biquanides

A

O. H Type 2 Reduce hepatic glucose production Decrease weight Increase insulin sensitivity to muscle and fat cell Decrease resistance Improve lipid levels Once or twice per day (10am or 10am and 6pm) Met forming (glucophAge) 500-1000mg Side effects Metallic taste Diarrhea Hypoglycemia and lactic acidosis (Rarf) N-v Bloating- cramping Decrease lipid levels Caution- liver and kidney disease- excessive alcohol

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26
Q

Thiazolidinediones

A

Oh type 2 Decrease insulin resistance Increase sensitivity Decrease hepatic glucose production Similar actions to biquanides Without regards to meals Once or twice a day Pioglitazome (actos) 20-40mg / day Rosiglitazone (avandia) 4-8mg 1 or 2 times a day (black box warning ) Side effects Increase urti Sinusitis Headache back pain Diarrhea CHF (look for edema v/s)

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27
Q

Depeptidyl peptidase 4 inhibitor

A

Oh type 2 Inihibits breakdown of intention (aids in absorption of glucose) hormones Helps release insulin Suppresses glucagon release Not used alone poly therapy Sitagliptin (januvia) 100mg daily (works in gut) Side effects Increase respiratory infections (assess temp NBC lung sounds)Adjuvant to diet and exercise

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28
Q

Amylin Analogue

A

O h Type 1 Mimic amylin (hormone in our body) Released by beta cells pancreas Usually work w insulin to lower blood sugar level Doses in mcg Based on patient 30 min before meals.

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29
Q

Meglititinies

A

Oh Type 2 Stimulates Insulin release From the pancreas (beta cells in pancreas) 15-30 min before meal Repaglinide (prandin) 1/2mg-4mg 2-3x daily Side effects Hypoglycemics Back pain Hepatotoxic (monitor liver profile) Urt 1 Bronchitis Rhinitis

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30
Q

Increntin mimetic

A

Oh type 2 Increase insulin secretion from beta cells Slows gastric emptying Suppresses glucagon Found in gi tract Exenatide (byetta) sub q 5mcg 2x daily Side effects Gastrotoxicity (nv,abdominal pain) Hypoglycemia

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31
Q

Hyperglycemia (diabetic coma/ ketoacidosis)

A

High blood sugar > 150 Keatons -glucose cannot be used so fats are used for metabolism Cause Too little insulin Mixed dose Too much food StressAlcohol consumption Illness (nvd) S/S N-V anorexia irritable abdominal pain and distension skin flushed- got dry mouth increase urine output decrease body fluid decrease BP increase HR Fruity odor to breath Kussmal breathing/ respiration ( Air hunger) (rapid deep breathing)

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32
Q

Diabetes Mellitus

A

Insufficient insulin production. Defective insulin production Chronic: no cure Type 1- insulin dependent Requires insulin administration Little to no insulin produced Rapid onset and more severe Type 2 Non insulin dependent Decrease production of insulin Decrease cell sensitivity to insulin Onset is insidious( they don’t realize) Treat w po drugs S/s Increase urine Dehydration Wounds slow to heal

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33
Q

Insulin

A

Hormones that regulates glucose metabolism and transporting of glucose across the cell membrane Controls use of protein fat glucose Inhibits glucose production by the liver Forms of insulin Animal Porcine-pork source (consider allergies and religion) Bovine- beef source Human Synthetic- humulin (yeast) (more cheap) Semisynthetic -novilin (genes) Syringes: u100, u50, u30, u500 (very rare) Insulin pen Route : always sub q Only regular insulin can be given IV 2 inches away from umbilicus Abdomen #1 spot (fast absorption) Rotate site (diff site diff day) 1 inch apart Pinch skin Done aspirate for insulin/ heparin Don’t massage- dont excersise (increase absorption) Sub q 90- back arm, thigh, too of butt (fatty portion) Profilled multidisciplinary pen syringes are for single patient use only Insulin pump- a monitor *only human insulin Basil Bolis Protein-decrease rate of absorption Zinc-modify onset of duration Assessment prior to insulin administration Blood glucose 1/2 hour ac+hs Urine glucose- not the 1st void Use the next void Np0 6 hours q finger stick

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34
Q

Hypoglycemia (insulin reaction/ shock)

A

Low blood sugar <60 repeat process Once in normal range give complex carb Skin milk, crackers 1/2 sandwiches Give within a hour 10-15gran of simple carb 6oz fruit juice regular soda 2-3 sugar cubes Honey/ corn syrup 5-6 hand candy Meds ^ sugar blood levels Glucagon (hormone produces by pancreas/ alpha cells (non beta) 1mg dose -sub IM IV Cannot be mixed with other things in syringe Can not be mixed with 0.9% NS Dextrose 50% (d 50) iv push followed by infusion

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35
Q

Diabetes Mellitus

A

Chronic Insufficient insulin production Defective Insulin production Two types

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36
Q

Type 1 diabetes

A

Little to no insulin producedRapid onset and more severe Requires insulin administration

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37
Q

Type 2 diabetes

A

Decreased production of insulin Decreased cell sensitivity to insulin Onset insidious Treat with oral drug

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38
Q

Insulin

A

Hormone produced by beta cells of the pancreas Controls use of glucose protein and fat Aids in transportation of glucose across cell membrane Inhibits glucose production by the liver

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39
Q

Synthetic insulin

A

Humulin

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40
Q

Semisynthetic insulin

A

Novolin

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41
Q

Insulin strength

A

u 100 and u 500

42
Q

Insulin is classified as

A

Rapid Short Intermediate Long acting and mixed insulins

43
Q

Protein does what to insulin

A

Decreases the rate of absorption

44
Q

Zinc does what to insulin

A

Modifies the onset and duration

45
Q

Signs and symptoms of hypoglycemia

A

N & V diarrhea hunger inability to concentrate confusion. Nervousness anxiety tremors tachycardia Pale cold clang skin Tired drowsy lethargic coma

46
Q

Cause of hypoglycemia

A

Too much insulin or wrong type Delay or omission of food Too much excersise Illness Diarrhea vomiting

47
Q

In someone who is hypoglycemia their sugar keytones are

A

Negative

48
Q

How to treat hypoglycemia

A

10-15 grand of simple cho -6oz fruit juice, non diet soda Cube sugar honey or corn syrup 5-6 life savers 2-3 glucose tabs or gel Followed by complex CHO with 1 hour skim milk crackers or meal

49
Q

Hyperglycemia signs and symptoms

A

N and v abdominal pain dissension anorexia dry mouth irritability got flushed skin fruity odor to breath kussmauls respiration increase urinalysis output

50
Q

Wgst causes hyper glycemis

A

Too little insulin Misses dose Unregulated or extra meals Stress Increase alcohol consumption N and v diarrhea infection

51
Q

When mixing insulin what should you do

A

Roll vial in palm of your hands do not shake

Air –> Cloudy –> then clear
Med –> clear –> then cloudy

52
Q

Where should insulin be stored

A

unopened in the refrigerator.
opened insulin should be stored at room temp for 30 days.

if the exp. date is less than 30 days then keep it until exp. date

53
Q

Lypodystrophy

A

destruction of fatty tissue.

rotate sites when giving cold insulin to prevent lypodystrophy

54
Q

Hyperglycemia (Diabetic Coma / Ketoacidosis) Signs and Symptoms

A

N&V, Abdominal Pain, Anorexia, Irritable, SKIN HOT AND FLUSH, Dry mouth, FRUITY ODOR to the breath, Kussmaul’s Respirations. increased URINE OUTPUT, DECREASED B/P, INCREASED HEART RATE

55
Q

Causes of hyperglycemia

A

Too little insulin or missed dose. Too much food, unregulated meals. stress. alcohol consumption, illness

56
Q

Sulfonylureas

A

stimulate the beta cells to release insulin. effective but decreased effectiveness overtime. Take a.c. of the day

57
Q

Examples of Sulfonylureas

A

Diabinese, Micronase, Glucotrol

58
Q

Alpha Glucosidase Inhibitor

A

(Maltase) A Carb blocker. Delays carbohydrate digestion + absorption. Helps LOWER B/P Take with 1st bite of meal

59
Q

Biguanides

A

Metformin (Glucophage) Reduce hepatic glucose production
Increases insulin sensitivity to muscle fat cells
Reduce insulin resistance
Decrease weight
improve lipid levels

60
Q

Increntin Mimetic

A

INCREASE INSULIN SECRETIONS from beta cells
suppress glucagon secretion
slow gastric empyting

61
Q

Examples of Incretin Mimetics

A

Exenatide (Byetta)

62
Q

Dipeptidyl Peptidase 4 Inhibitor

A

acts in absorbing glucose,
inhibit the breakdown of incretin hormones
adjuvant to diet and exercise

63
Q

Examples of Dipeptidyl Peptidase 4 Inhibitors

A

Stagliptin (Januvia)

Saxagliptin (Onglyza)

64
Q

Amylin Analogue

A

Amylinomimetic
Slows the movement of food through the stomach
Adult 1 + 2 diabetes that need blood sugar coults
MUST BE GIVEN WITH INSULIN

65
Q

example of an amylin analogue

A

zamlintide duclate (symlin)

66
Q

Combination Drug : Metaglip

A

Metformin , Glipizide

67
Q

Combination Drug : Avandamet

A

Metformin , Avandia

68
Q

Combination Drug : Glucovance

A

Metformin , Glipizide

69
Q

Combination Drug : Actoplus met

A

Pioglitazone , Metformin

70
Q

Combination Drug : Ductact

A

Pioglitazone , Glimepiride

71
Q

Combination Drug : Glucorana

A

Rosiglitazone , Metformin

72
Q

Adrenocorticotropic Hormone

A

Anterior lobe stimulates the adrenal cortex to produce glucocorticoids.
Used to diagnose adrenocortical functions, multiple sclerosis

73
Q

Meglitinides

A

Stimulates insulin release from the pancreas

74
Q

Examples of Meglitinides

A

Nateglinide , Repaglinide

75
Q

Thiazolidinediones

A

decreased hepatic glucose production
decreased sugar released by the liver
decreases insulin resistance
increases insulin sensitivity

76
Q

Examples of thiazolidinediones

A

Pioglitazone (actos)

Rosiglitazone (Avandia)

77
Q

Synthroid

A

Thyroid Replacement Drug. Increases metabolic rate by replacing thyroid hormone t3 and t4 replacement therapy in hyperthyroidism

78
Q

Drugs used in thyroid replacement

A

Levothyroxine (Synthroid) t4
Liothyroxine Na (cytomel) t3
Liotrix (Euthyroid) t3 or t4
Thyroglobulin (Proloid) t3 or y4

79
Q

How to store thyroid replacement drugs

A

Store in a DARK bottle
Replace after 3 months
Avoid iodide, salt, MVI on skin
Maintain and record apical pulse

80
Q

Thiouracils

A

Return to euthyroid state
inhibit synthesis and release of the thyroid hormone
prevent the CONVERSION OF t4 to t3 IN PERIPHERAL CIRCULATION

81
Q

Iodides

A

Anthyroid medication Reduces size and vascularity of the thyroid gland

82
Q

Example of Iodide (Potassium Iodide)

A

Thryosafe , Thyroshield

83
Q

Radioactive Iodine

A

antithyroid drug Emits beta rays which destroy hyperactive thyroid cells

84
Q

Parathyroid Agents

A

Calcitonin (used to treat hyperthyroidism)

85
Q

Hypoparathyroid drugs (hypo secretion)

A

Calcium Carbonate
Calcium Gluconate
Parathyroid Extract
Calcitriol (Rocaltrol)

86
Q

Glyburdie

A

Micronase/DIA Beta
Used with diet and exercise to help control blood sugar in patients with type 2 diabetes.
Brand names: Micronase, DiaBeta, Glynase
Drug class: Sulfonylurea

87
Q

Vasopressin

A

Pitressin
One of the most important roles of AVP is to regulate the body’s retention of water; it is released when the body is dehydrated and causes the kidneys to conserve water, thus concentrating the urine and reducing urine volume. At high concentrations, it also raises blood pressure by inducing moderate vasoconstriction.

88
Q

Levothyroxine

A

Synthroid
Treats hypothyroidism. Also treats an enlarged thyroid gland (goiter) and thyroid cancer.

Brand names: Tirosint, Synthroid, Levothroid, Unithroid, Levoxyl, Novothyrox

89
Q

Propylthiouracil

A

(PTU)
Treats Graves’ disease and hyperthyroidism (too much thyroid hormone from the thyroid gland) in patients who have already been treated with other medicines (such as methimazole) that did not work well.

Drug class: Thyroid Hormone Synthesis Inhibitor
Other drugs in same class: Methimazole
May treat: Hyperthyroidism, Enlarged thyroid, Thyrotoxic crisis

90
Q

Calcitriol

A

Rocaltrol
Treats low blood calcium in kidney dialysis patients and other patients. Calcitriol is a form of vitamin D.
Drug class: Vitamin D3 Analog
Brand names: Rocaltrol, Vectical, Calcijex

91
Q

Potassium Iodide

A

SSKI

123456789

92
Q

Desmopressin

A

DDAVP
Prevents or controls thirst and frequent urination caused by diabetes insipidus and certain brain injuries.

May treat: Diabetes insipidus, Bleeding, Enuresis, Thrombocytopenia
Drug classes: Vasopressin analogue, Factor VIII Activator

93
Q

Calcitonin

A

Calcimar
acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone

Salmon calcitonin is used for the treatment of:
Postmenopausal osteoporosis
Hypercalcaemia
Paget's disease
Bone metastases
Phantom limb pain[15]
94
Q

Metformin HCL

A

Glucophage

Glucophage and Glucophage XR (metformin hydrochloride) are oral antihyperglycemic drugs used to treat type 2 diabetes.

95
Q

Acarbose

A

Precose
Helps control blood sugar in patients who have diabetes mellitus.

Drug class: Alpha-glucosidase inhibitor
Other drugs in same class: Miglitol
May treat: Type 2 diabetes mellitus
Brand name: Precose

96
Q

Chlorpromide

A 
Diabenese
Treats diabetes mellitus. Belongs to a class of drugs called sulfonylureas.
97
Q

Glimepiride

A

Amaryl
Treats type 2 diabetes. Used together with a proper diet and exercise to help control high blood sugar. This medicine is a sulfonylurea.

Brand name: Amaryl
Drug class: Sulfonylurea
Other drugs in same class: Glibenclamide, Glipizide, Tolbutamide

98
Q

Sitagliptin

A

Januvia
Treats type 2 diabetes. Used together with proper diet and exercise to help control high blood sugar.

Brand name: Januvia
Drug class: Dipeptidyl peptidase-4 inhibitor

99
Q

Humalog Novolog and Apidra are all examples of

A

Rapid Acting Insulin

100
Q

Humulin R and Novolin R are examples of

A

Short acting Insulin

101
Q

Humulin N and Novolin N are examples of

A

Intermediate Insulin

102
Q

Levemir and Lantus are examples of

A

Long Lasting Insulin

Felder (9 decks)

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